US
,MLE Step 2 CK & NBME Shelf Exams
2025/2026: 1400+ High-Yield Clinical
Questions with Verified Answers (IM, OB-GYN,
Congenital dermal melocytosis, benign, flat blue-grey patches on the lower back and buttocks that is
common in African, Asian, Hispanic, and Native American ethnicity.
Mongolian spots -> usually fade spontaneously
-> document these as they can be mistaken for bruises
What is the most common cause of acute, unilateral lymphadenitis in children?
Staph aureus followed by group A strep
Pts w/ bacterial lymphadenitis usually < 5 y/o and nontoxic, tender lymph node, warm, erythematous, 3-
6 cm in size Unilateral acute cervical lymphadenitis
All sexually active women < 24 should undergo which screening?
Chlamydia trachomatis and Neisseria gonorrhoea
-> recommended for any person with new partner in past 2 mo., multiple partners, history STI, illicit
drug use, incarceration, contact with sex workers
-> cervicitis asymptomatic often can lead to PID -> infertility, ectopic pregnancy, chronic pelvic pain
Best screening test for Chlamydia trachomatis and Neisseria gonorrhoeae by?
Nucleic acid amplification testing which has high sensitivity and specificity
-> can be done urine, endocervical, vaginal, or urethral specimens
Can sit momentarily on propped hands, transfer objects from hand to hand, and respond to name.
Stranger anxiety develops at this age.
healthy 6 mo. old
Pts with Sickle cell anemia suffer from chronic extravascular and intravascular hemolysis. Characteristic
lab findings include?
,Mild to moderate anemia w/ reticulocytosis + unconjugated hyperbilirubinemia, INC lactate
dehydrogenase, low to absent serum haptoglobin
-> Acute worsening of anemia can occur from splenic sequestration with manifests as splenomegaly and
INC fatigue
___ are the antibiotics of choice for pertussis treatment and post-exposure prophylaxis. All close
contacts should be given this antibiotic regardless of age, immunization status or symptoms.
Macrolides
Age < 1 mo. = Azithromycin 5 days
Age > 1 mo. = Azithromycin x 5 days/Clarithromycin x 7 days/ Erythromycin x 14 days
Lethargy, fever, poor oral intake, vomiting presentation, nuchal rigidity of bacterial meningitis in infant
what should be performed next?
Lumbar puncture before antibiotics
Infants critically ill (status epilepticus, septic shock) antibiotics before lumbar puncture
Head CT -> comatose infants
Indications for imaging prior to LP for bacterial meningitis suspected in children > 1 mo.
Hx hydrocephalus or neurosurgical procedure
Hx head trauma
Coma or focal neuro findings
Tx Bacterial meningitis in children age > 1 mo.
IV Vanco & Ceftriaxone
OR
Cefotaxime
Dexamethasone for H. influenzae type b meningitis
Fever, toxicity, gray-white pharyngitis, sandpaper-like rash, circumoral pallor.
Scarlet fever -> strawberry tongue
Group A strep erythrogenic exotoxin
, tx: Penicillin V
What is herpangina?
Throat infection caused by enteroviruses such as Cox A, high fever, sore throat complete inability to
swallow, ulcerative lesions palate, tonsils, pharynx
palms and sole rash, hand-foot-mouth disease
The most important risk factors for respiratory distress syndrome (RDS) is?
Prematurity
-> male sex, prenatal asphyxia, maternal diabetes, cesarean section
Maternal diabetes -> INC incidence by delaying maturation of pulmonary surfactant production (high
levels insulin in fetus inhibits cortisol and blocks maturation sphingomyelin)
Tx RDS
Antenatal prevention w/ corticosteroids and postnatal tx w/ exogenous surfactant
Space occupying lesion in the parietal lobe in a child what is the most common tumor type?
CNS tumors most common solid tumors => Astrocytoma most common supratentorial and infratentorial
groups
In pediatric population, infratentorial tumors are more common than supratentorial tumors, benign
astrocytomas are the most common histo type
Define primary amenorrhea.
Absence of menarche by age 15
What is the first step in the evaluation of primary amenorrhea?
Pelvic exam determine ovaries, uterus, and vagina are present or absent
US is preferred imaging modality to evaluate anatomy of repro tract
What does US show for Turner syndrome?
One of the most common causes of primary amenorrhea
-> primary ovarian failure gonadal dysgenesis followed by early menopause and infertility -> pelvic US
show an infantile uterus and "streak ovaries"
True/False: Human milk protein absorbs better and improves gastric emptying.
TRUE - ideal form of nutrition for term infants until 6 mo. age the major protein source is whey, which is
more easily digested than casein and helps to improve gastric empty
,MLE Step 2 CK & NBME Shelf Exams
2025/2026: 1400+ High-Yield Clinical
Questions with Verified Answers (IM, OB-GYN,
Congenital dermal melocytosis, benign, flat blue-grey patches on the lower back and buttocks that is
common in African, Asian, Hispanic, and Native American ethnicity.
Mongolian spots -> usually fade spontaneously
-> document these as they can be mistaken for bruises
What is the most common cause of acute, unilateral lymphadenitis in children?
Staph aureus followed by group A strep
Pts w/ bacterial lymphadenitis usually < 5 y/o and nontoxic, tender lymph node, warm, erythematous, 3-
6 cm in size Unilateral acute cervical lymphadenitis
All sexually active women < 24 should undergo which screening?
Chlamydia trachomatis and Neisseria gonorrhoea
-> recommended for any person with new partner in past 2 mo., multiple partners, history STI, illicit
drug use, incarceration, contact with sex workers
-> cervicitis asymptomatic often can lead to PID -> infertility, ectopic pregnancy, chronic pelvic pain
Best screening test for Chlamydia trachomatis and Neisseria gonorrhoeae by?
Nucleic acid amplification testing which has high sensitivity and specificity
-> can be done urine, endocervical, vaginal, or urethral specimens
Can sit momentarily on propped hands, transfer objects from hand to hand, and respond to name.
Stranger anxiety develops at this age.
healthy 6 mo. old
Pts with Sickle cell anemia suffer from chronic extravascular and intravascular hemolysis. Characteristic
lab findings include?
,Mild to moderate anemia w/ reticulocytosis + unconjugated hyperbilirubinemia, INC lactate
dehydrogenase, low to absent serum haptoglobin
-> Acute worsening of anemia can occur from splenic sequestration with manifests as splenomegaly and
INC fatigue
___ are the antibiotics of choice for pertussis treatment and post-exposure prophylaxis. All close
contacts should be given this antibiotic regardless of age, immunization status or symptoms.
Macrolides
Age < 1 mo. = Azithromycin 5 days
Age > 1 mo. = Azithromycin x 5 days/Clarithromycin x 7 days/ Erythromycin x 14 days
Lethargy, fever, poor oral intake, vomiting presentation, nuchal rigidity of bacterial meningitis in infant
what should be performed next?
Lumbar puncture before antibiotics
Infants critically ill (status epilepticus, septic shock) antibiotics before lumbar puncture
Head CT -> comatose infants
Indications for imaging prior to LP for bacterial meningitis suspected in children > 1 mo.
Hx hydrocephalus or neurosurgical procedure
Hx head trauma
Coma or focal neuro findings
Tx Bacterial meningitis in children age > 1 mo.
IV Vanco & Ceftriaxone
OR
Cefotaxime
Dexamethasone for H. influenzae type b meningitis
Fever, toxicity, gray-white pharyngitis, sandpaper-like rash, circumoral pallor.
Scarlet fever -> strawberry tongue
Group A strep erythrogenic exotoxin
, tx: Penicillin V
What is herpangina?
Throat infection caused by enteroviruses such as Cox A, high fever, sore throat complete inability to
swallow, ulcerative lesions palate, tonsils, pharynx
palms and sole rash, hand-foot-mouth disease
The most important risk factors for respiratory distress syndrome (RDS) is?
Prematurity
-> male sex, prenatal asphyxia, maternal diabetes, cesarean section
Maternal diabetes -> INC incidence by delaying maturation of pulmonary surfactant production (high
levels insulin in fetus inhibits cortisol and blocks maturation sphingomyelin)
Tx RDS
Antenatal prevention w/ corticosteroids and postnatal tx w/ exogenous surfactant
Space occupying lesion in the parietal lobe in a child what is the most common tumor type?
CNS tumors most common solid tumors => Astrocytoma most common supratentorial and infratentorial
groups
In pediatric population, infratentorial tumors are more common than supratentorial tumors, benign
astrocytomas are the most common histo type
Define primary amenorrhea.
Absence of menarche by age 15
What is the first step in the evaluation of primary amenorrhea?
Pelvic exam determine ovaries, uterus, and vagina are present or absent
US is preferred imaging modality to evaluate anatomy of repro tract
What does US show for Turner syndrome?
One of the most common causes of primary amenorrhea
-> primary ovarian failure gonadal dysgenesis followed by early menopause and infertility -> pelvic US
show an infantile uterus and "streak ovaries"
True/False: Human milk protein absorbs better and improves gastric emptying.
TRUE - ideal form of nutrition for term infants until 6 mo. age the major protein source is whey, which is
more easily digested than casein and helps to improve gastric empty
