THE USMLE STEP 2 CK.(CLINICAL KNOWLEDGE) LATEST
EDITION QUESTION AND ANSWERS
pregnant with active HBV tx newborn with HBIG and HBV vaccine
hypotension, JVD, muffled heart sounds (also pulsus
Beck's triad for tamponade
paradoxus). Electrical alternans
increased ADH and BNP --> hyponatremia. Tx -
subarachnoid hemorrhage
water restriction
SW US, central/south America. Pulm infection -
coccidioidomycosis dry cough, weight loss, pleuritic chest pain,
erythema multiforme/nodosum, arthralgias
SE US, mid Atlantic, central US, caves. Acute
PNA, but usually asymptomatic. HIV
histoplasmosis disseminated infection- hilar LAD, pneumonitis,
pancytopenia, hepatosplenomegaly, palatal
ulcers. tx- IV amphotericin B followed by
lifelong itraconazole.
central US (most in Wisconsin). Often
asymptomatic or flu-like Sx. Systemic disease-
Blastomycosis
lytic bone lesions, pulmonary infection, skin
lesions. Dx- broad-based budding yeast. Tx-
itraconazole, amphotericin B
invasive in IMCD. CXR - cavitary lesions. CT - pulm
aspergillosis
nodules, halo sign, air crescent
, subcutaneous infection. Gardeners. Travel up
sporotrichosis lymphatics for nodules on forearms
pulm infection often asymptomatic.
cryptococcus
Usually meningoencephalitis in HIV with
CD4<200
Listeria monocytogenes, Yersinia
hemochromatosis infections
enterocolitica, septicemia - Vibrio vulnificus
methyldphenidate, modafinil, antidepressants (for
Narcolepsy treatment
cataplexy)
galactorrhea test B-HCG, prolactin, TSH
cervical/blood cultures, antibiotics, gentle suction
septic abortion
currettage
x-linked recessive, HPRT deficiency, increased
Lesch-Nyhan uric acid. Sx - self mutilation, dysto nia, spacticity,
gout. Presents at 6 months.
tx - prednisone, cyclophosphamide for
minimal change disease
resistant cases/frequent relapse
seizure s, retardatio n, trigeminal port-wine stain,
Sturge-Weber hemi neuro findings, tramline intracranial
calcifications
, seizures, retardation, intracranial calcifications
tuberous sclerosis (tubers), ashleaf spots, adenoma sebaceum
(red papules on face)
autosomal dominant. Type 1 collagen problem. Type
2 most severe with perinatal fractures and often
intrauterine death. Blue sclera, fractures, hypotonia,
osteogenesis imperfecta
hearing loss, joint hypermobility, dentinogenesis
imperfecta
neck/shoulder/hip pain/stiffness. >50 years old, high
polymyalgia rheumatica ESR. Tx- low dose prednisone, high dose for
temporal arteritis
citrate anticoagulant --> chelates Ca and Mg --> low
massive blood transfusion
Ca --> paresthesias, hyperactive reflexes
dyslipidemia, accelerated atherosclerosis,
hypercoagulable, risk for MI/stroke, higher infxn
nephrotic syndrome
susceptibility. Can have renal vein thrombosis,
usually with membranous GN
early diastolic (mild) to holodiastolic (severe)
murmur. Bounding pulses. Tx- decrease afterload
aortic regurgitation
with DHP Ca-channel blockers, ACEi, NOT beta
blockers.
erythema multiforme. No cell wall so not on gram
mycoplasma PNA
stain
, pseudohyphae. In IMCD and Abx treated people.
candidal vulvovaginitis
Tx- oral fluconazole, topical nystatin
nonseminomatous germ cell large anterior mediastinal mass, young males. High
tumor HCG and AFP.
EDITION QUESTION AND ANSWERS
pregnant with active HBV tx newborn with HBIG and HBV vaccine
hypotension, JVD, muffled heart sounds (also pulsus
Beck's triad for tamponade
paradoxus). Electrical alternans
increased ADH and BNP --> hyponatremia. Tx -
subarachnoid hemorrhage
water restriction
SW US, central/south America. Pulm infection -
coccidioidomycosis dry cough, weight loss, pleuritic chest pain,
erythema multiforme/nodosum, arthralgias
SE US, mid Atlantic, central US, caves. Acute
PNA, but usually asymptomatic. HIV
histoplasmosis disseminated infection- hilar LAD, pneumonitis,
pancytopenia, hepatosplenomegaly, palatal
ulcers. tx- IV amphotericin B followed by
lifelong itraconazole.
central US (most in Wisconsin). Often
asymptomatic or flu-like Sx. Systemic disease-
Blastomycosis
lytic bone lesions, pulmonary infection, skin
lesions. Dx- broad-based budding yeast. Tx-
itraconazole, amphotericin B
invasive in IMCD. CXR - cavitary lesions. CT - pulm
aspergillosis
nodules, halo sign, air crescent
, subcutaneous infection. Gardeners. Travel up
sporotrichosis lymphatics for nodules on forearms
pulm infection often asymptomatic.
cryptococcus
Usually meningoencephalitis in HIV with
CD4<200
Listeria monocytogenes, Yersinia
hemochromatosis infections
enterocolitica, septicemia - Vibrio vulnificus
methyldphenidate, modafinil, antidepressants (for
Narcolepsy treatment
cataplexy)
galactorrhea test B-HCG, prolactin, TSH
cervical/blood cultures, antibiotics, gentle suction
septic abortion
currettage
x-linked recessive, HPRT deficiency, increased
Lesch-Nyhan uric acid. Sx - self mutilation, dysto nia, spacticity,
gout. Presents at 6 months.
tx - prednisone, cyclophosphamide for
minimal change disease
resistant cases/frequent relapse
seizure s, retardatio n, trigeminal port-wine stain,
Sturge-Weber hemi neuro findings, tramline intracranial
calcifications
, seizures, retardation, intracranial calcifications
tuberous sclerosis (tubers), ashleaf spots, adenoma sebaceum
(red papules on face)
autosomal dominant. Type 1 collagen problem. Type
2 most severe with perinatal fractures and often
intrauterine death. Blue sclera, fractures, hypotonia,
osteogenesis imperfecta
hearing loss, joint hypermobility, dentinogenesis
imperfecta
neck/shoulder/hip pain/stiffness. >50 years old, high
polymyalgia rheumatica ESR. Tx- low dose prednisone, high dose for
temporal arteritis
citrate anticoagulant --> chelates Ca and Mg --> low
massive blood transfusion
Ca --> paresthesias, hyperactive reflexes
dyslipidemia, accelerated atherosclerosis,
hypercoagulable, risk for MI/stroke, higher infxn
nephrotic syndrome
susceptibility. Can have renal vein thrombosis,
usually with membranous GN
early diastolic (mild) to holodiastolic (severe)
murmur. Bounding pulses. Tx- decrease afterload
aortic regurgitation
with DHP Ca-channel blockers, ACEi, NOT beta
blockers.
erythema multiforme. No cell wall so not on gram
mycoplasma PNA
stain
, pseudohyphae. In IMCD and Abx treated people.
candidal vulvovaginitis
Tx- oral fluconazole, topical nystatin
nonseminomatous germ cell large anterior mediastinal mass, young males. High
tumor HCG and AFP.
