UWORLD STEP 2 CK USMLE REAL STUDY
GUIDE WITH 900 COMPLETE TERMS WELL
ANSWERED/RATED 5 STAR
[Skip] How does aspirin impact prostaglandin production? - ANSWER>>Dec (remember: prostaglandins
are protective to the gastric mucosa)
Pre-term labor management at 34 0/7 to 36 6/7 - ANSWER>>+/- Betamethasone (Steroids)
PCN if GBS positive or unknown
Pre-term labor management at 32 0/7 to 33 6/7 - ANSWER>>Betamethasone
Tocolytics
PCN if GBS positive or unknown
Pre-term labor management at < 32 - ANSWER>>Betamethasone
Tocolytics
Magnesium for fetal neuroprotection
PCN if GBS positive or unknown
Indications for giving a mom PCN for GBS when she's <37 weeks and getting a c-section - ANSWER>>GBS
positive or unknown AND ruptured membranes
Main drugs that cause esophagitis - ANSWER>>Tetracyclines
Aspirin
NSAIDs
Alendronate
Potassium chloride
Iron
Quinidine
80% of limb ischemia causes - ANSWER>>Arterial emboli from the heart
Symptoms are sudden in onset (Thrombus would be more insidious)
MC from underlying Afib or a LV thrombus from a recent MI
Algorithm for suspected variceal hemorrhage - ANSWER>>Volume resuscitation ideally w/ 3 large bore
needles
IV octreotide for active bleeds (somatostatin analogue that inhibits the release of vasodilator hormones,
which causes splanchnic vasoconstriction and a dec in portal flow
Urgent endoscopy therapy w/in 2 hrs
[Skip] MC clavicular fracture location - ANSWER>>middle 1/3
Pain + immobility of an injured arm + contralateral arm is used to support the weight of the affected arm
+ ipsilateral shoulder is displaced inferior & posterior --> dx? - ANSWER>>Clavicle fracture (careful
inspection is needed to make sure the underlying subclavian A & brachial plexus are not damaged)
,If you hear a bruit --> angiogram
MC organism causing infection of the prosthetic joint placed < 3 months ago - ANSWER>>Staph aureus
G (-) rods
Anaerobes
MC organism causing infection of the prosthetic joint placed > 3 months ago - ANSWER>>Coagulase
negative staph
Propionibacterium
Enterococci
[Skip] Insertion location for chest decompression for a tension pneumothorax - ANSWER>>2nd IC space
(2nd-3rd rib) at the mid-clavicular line
Defect at the linea alba that is covered with skin and possibly contains bowel & umbilical cord that
inserts at the apex of the defect --> dx and associations? - ANSWER>>Pediatric umbilical hernia 2/2
incomplete abdominal wall muscle closure around the umbilical ring
Asc w/ Ehlers-Danlos, Beckwidth-wiedemann & hypothyroidism
May close spontaneously
[Skip] Placement of amputated limb - ANSWER>>Wrapped in saline moistened gauze, sealed in a plastic
bag & placed on ice
Next step when urethra is suspected to be injured - ANSWER>>Retrograde urethrogram
Increased pain with neck flexion --> sign of? - ANSWER>>Meningitis
[Skip] Acalculous cholecystitis + stable pt--> tx? - ANSWER>>Cholecystectomy
Acalculous cholecystitis + unstable pt --> tx? - ANSWER>>Abx + percutaneous drainage of GB --> pt
stabilized --> cholecystectomy
1st assessment after blunt abdominal trauma - ANSWER>>Check for intraperitoneal free fluid or
hemorrhage via US
Symptoms of a complete proximal small bowel obstruction - ANSWER>>Early vomiting
Abdominal discomfort
Abnormal contrast filling on x-ray
Symptoms of a mid or distal small bowel obstruction - ANSWER>>Colicky abdominal pain
Delayed emesis
Prominent abdominal distention
Constipation-obstipation
Hyperactive BS
Dilated loops of bowel on abdominal x-ray
,Hypotension + extensive blood loss into the tissues + massive blood replacement + jaundice 2-3 days
post-op --> +/- dx, lab values, pathogenesis? - ANSWER>>Post-op cholestasis
Very elevated ALP
Normal or inc AST & ALT
Inc pigmentation d/t transfusion, dec liver function d/t hypotension, dec renal bilirubin excretion d/t
tubular necrosis
Penile snapping sensation --> pain --> dx, tx? - ANSWER>>Penile fracture (snapping 2/2 to tearing of the
tunica albuginea)
Emergent urethrogram surgery to evacuate the hematoma & repair the tunica albuginea
[Skip] What causes the penis to bend during a penile fracture? - ANSWER>>Rapidly forming hematoma
[Skip] Easiest way to inc FRC - ANSWER>>Elevate the head of the bed
[Skip] Common post-gastrectomy complication - ANSWER>>Dumping syndrome
Dumping syndrome pathogenesis & tx - ANSWER>>Rapid emptying of hypertonic gastric content into
the duodenum --> fluid shift from intravascular space to small intestine, release of intestinal vasoactive
polypeptides & stimulation of autonomic reflexes
TX = dietary modification
Acute pain + swelling of the midline sacrococcygeal skin/subQ tissues --> +/- dx, tx? -
ANSWER>>Infection of the pilonidal cyst mainly in young males
TX = drain abscess, excision of sinus tract
[Skip] First step in the tx of acute hemorrhage - ANSWER>>Establish vascular access with 2 large bore IV
needles or a central line
TX of pancreatic abscess - ANSWER>>Immediate placement of a percutaneous drainage catheter, CX
fluid, and ultimately a surgical debridement
Lab levels in Paget's disease - ANSWER>>Normal serum Ca2+
Normal serum phosphate
Inc alk phos
Inc urine hydroxyproline
Begin heparin --> platelets drops --> clincal dx, gold standard for dx, tx? - ANSWER>>HIT type 2
Clinical dx = Heparin exposure >5 days & ANY of the following:
(1) Platelet count reduction >50% from baseline
(2) Arterial or venous thrombosis
(3) Necrotic skin lesions at heparin injection sites
(4) Acute systemic (anaphylactoid) reactions after heparin
Gold dx = serotonin release assay
TX = stop heparin, start argatroban or fondaparinux
[Skip] HIT type 1 vs type 2 - ANSWER>>Type 1 = direct impact that heparin has on platelets
Type 2 = autoimmune induced
, Alopecia + skin lesion + abnormal taste + impaired wound healing --> dx? - ANSWER>>Zinc deficiency
May be 2/2 TPN or malabsorption
Viral Conjunctivitis:
Eye involvement
Eye "struck shit" in AM
Discharge
Discharge reappears after wiping
Other complaints
Conjunctival appearance - ANSWER>>Unilateral (may progress to bilateral)
Yes
Watery/scant mucous
No
Burning, sandy, gritty, viral prodrome
Diffuse injection, follicular/bumpy
Bacterial Conjunctivitis:
Eye involvement
Eye "struck shit" in AM
Discharge
Discharge reappears after wiping
Other complaints
Conjunctival appearance - ANSWER>>Unilateral (may progress to bilateral)
Yes
Purulent/thick
Yes
Unremitting discharge
Diffuse injection, non-follicular
Allergic Conjunctivitis:
Eye involvement
Eye "struck shit" in AM
Discharge
Discharge reappears after wiping
Other complaints
Conjunctival appearance - ANSWER>>Bilateral
Yes
Watery/scant mucous
No
Itching
Diffuse injection, follicular/bumpy, edema
[Skip] When to bring a pt with SBO from conservative tx to surgery - ANSWER>>1. pt doesn't improve
with conservative tx
2. pt develops symptoms of strangulation
[Skip] Most important prognostic indicator for acute liver failure - ANSWER>>Prothrombin time
GUIDE WITH 900 COMPLETE TERMS WELL
ANSWERED/RATED 5 STAR
[Skip] How does aspirin impact prostaglandin production? - ANSWER>>Dec (remember: prostaglandins
are protective to the gastric mucosa)
Pre-term labor management at 34 0/7 to 36 6/7 - ANSWER>>+/- Betamethasone (Steroids)
PCN if GBS positive or unknown
Pre-term labor management at 32 0/7 to 33 6/7 - ANSWER>>Betamethasone
Tocolytics
PCN if GBS positive or unknown
Pre-term labor management at < 32 - ANSWER>>Betamethasone
Tocolytics
Magnesium for fetal neuroprotection
PCN if GBS positive or unknown
Indications for giving a mom PCN for GBS when she's <37 weeks and getting a c-section - ANSWER>>GBS
positive or unknown AND ruptured membranes
Main drugs that cause esophagitis - ANSWER>>Tetracyclines
Aspirin
NSAIDs
Alendronate
Potassium chloride
Iron
Quinidine
80% of limb ischemia causes - ANSWER>>Arterial emboli from the heart
Symptoms are sudden in onset (Thrombus would be more insidious)
MC from underlying Afib or a LV thrombus from a recent MI
Algorithm for suspected variceal hemorrhage - ANSWER>>Volume resuscitation ideally w/ 3 large bore
needles
IV octreotide for active bleeds (somatostatin analogue that inhibits the release of vasodilator hormones,
which causes splanchnic vasoconstriction and a dec in portal flow
Urgent endoscopy therapy w/in 2 hrs
[Skip] MC clavicular fracture location - ANSWER>>middle 1/3
Pain + immobility of an injured arm + contralateral arm is used to support the weight of the affected arm
+ ipsilateral shoulder is displaced inferior & posterior --> dx? - ANSWER>>Clavicle fracture (careful
inspection is needed to make sure the underlying subclavian A & brachial plexus are not damaged)
,If you hear a bruit --> angiogram
MC organism causing infection of the prosthetic joint placed < 3 months ago - ANSWER>>Staph aureus
G (-) rods
Anaerobes
MC organism causing infection of the prosthetic joint placed > 3 months ago - ANSWER>>Coagulase
negative staph
Propionibacterium
Enterococci
[Skip] Insertion location for chest decompression for a tension pneumothorax - ANSWER>>2nd IC space
(2nd-3rd rib) at the mid-clavicular line
Defect at the linea alba that is covered with skin and possibly contains bowel & umbilical cord that
inserts at the apex of the defect --> dx and associations? - ANSWER>>Pediatric umbilical hernia 2/2
incomplete abdominal wall muscle closure around the umbilical ring
Asc w/ Ehlers-Danlos, Beckwidth-wiedemann & hypothyroidism
May close spontaneously
[Skip] Placement of amputated limb - ANSWER>>Wrapped in saline moistened gauze, sealed in a plastic
bag & placed on ice
Next step when urethra is suspected to be injured - ANSWER>>Retrograde urethrogram
Increased pain with neck flexion --> sign of? - ANSWER>>Meningitis
[Skip] Acalculous cholecystitis + stable pt--> tx? - ANSWER>>Cholecystectomy
Acalculous cholecystitis + unstable pt --> tx? - ANSWER>>Abx + percutaneous drainage of GB --> pt
stabilized --> cholecystectomy
1st assessment after blunt abdominal trauma - ANSWER>>Check for intraperitoneal free fluid or
hemorrhage via US
Symptoms of a complete proximal small bowel obstruction - ANSWER>>Early vomiting
Abdominal discomfort
Abnormal contrast filling on x-ray
Symptoms of a mid or distal small bowel obstruction - ANSWER>>Colicky abdominal pain
Delayed emesis
Prominent abdominal distention
Constipation-obstipation
Hyperactive BS
Dilated loops of bowel on abdominal x-ray
,Hypotension + extensive blood loss into the tissues + massive blood replacement + jaundice 2-3 days
post-op --> +/- dx, lab values, pathogenesis? - ANSWER>>Post-op cholestasis
Very elevated ALP
Normal or inc AST & ALT
Inc pigmentation d/t transfusion, dec liver function d/t hypotension, dec renal bilirubin excretion d/t
tubular necrosis
Penile snapping sensation --> pain --> dx, tx? - ANSWER>>Penile fracture (snapping 2/2 to tearing of the
tunica albuginea)
Emergent urethrogram surgery to evacuate the hematoma & repair the tunica albuginea
[Skip] What causes the penis to bend during a penile fracture? - ANSWER>>Rapidly forming hematoma
[Skip] Easiest way to inc FRC - ANSWER>>Elevate the head of the bed
[Skip] Common post-gastrectomy complication - ANSWER>>Dumping syndrome
Dumping syndrome pathogenesis & tx - ANSWER>>Rapid emptying of hypertonic gastric content into
the duodenum --> fluid shift from intravascular space to small intestine, release of intestinal vasoactive
polypeptides & stimulation of autonomic reflexes
TX = dietary modification
Acute pain + swelling of the midline sacrococcygeal skin/subQ tissues --> +/- dx, tx? -
ANSWER>>Infection of the pilonidal cyst mainly in young males
TX = drain abscess, excision of sinus tract
[Skip] First step in the tx of acute hemorrhage - ANSWER>>Establish vascular access with 2 large bore IV
needles or a central line
TX of pancreatic abscess - ANSWER>>Immediate placement of a percutaneous drainage catheter, CX
fluid, and ultimately a surgical debridement
Lab levels in Paget's disease - ANSWER>>Normal serum Ca2+
Normal serum phosphate
Inc alk phos
Inc urine hydroxyproline
Begin heparin --> platelets drops --> clincal dx, gold standard for dx, tx? - ANSWER>>HIT type 2
Clinical dx = Heparin exposure >5 days & ANY of the following:
(1) Platelet count reduction >50% from baseline
(2) Arterial or venous thrombosis
(3) Necrotic skin lesions at heparin injection sites
(4) Acute systemic (anaphylactoid) reactions after heparin
Gold dx = serotonin release assay
TX = stop heparin, start argatroban or fondaparinux
[Skip] HIT type 1 vs type 2 - ANSWER>>Type 1 = direct impact that heparin has on platelets
Type 2 = autoimmune induced
, Alopecia + skin lesion + abnormal taste + impaired wound healing --> dx? - ANSWER>>Zinc deficiency
May be 2/2 TPN or malabsorption
Viral Conjunctivitis:
Eye involvement
Eye "struck shit" in AM
Discharge
Discharge reappears after wiping
Other complaints
Conjunctival appearance - ANSWER>>Unilateral (may progress to bilateral)
Yes
Watery/scant mucous
No
Burning, sandy, gritty, viral prodrome
Diffuse injection, follicular/bumpy
Bacterial Conjunctivitis:
Eye involvement
Eye "struck shit" in AM
Discharge
Discharge reappears after wiping
Other complaints
Conjunctival appearance - ANSWER>>Unilateral (may progress to bilateral)
Yes
Purulent/thick
Yes
Unremitting discharge
Diffuse injection, non-follicular
Allergic Conjunctivitis:
Eye involvement
Eye "struck shit" in AM
Discharge
Discharge reappears after wiping
Other complaints
Conjunctival appearance - ANSWER>>Bilateral
Yes
Watery/scant mucous
No
Itching
Diffuse injection, follicular/bumpy, edema
[Skip] When to bring a pt with SBO from conservative tx to surgery - ANSWER>>1. pt doesn't improve
with conservative tx
2. pt develops symptoms of strangulation
[Skip] Most important prognostic indicator for acute liver failure - ANSWER>>Prothrombin time
