FIRST AID USMLE STEP 2 CS - MINI
CASES EXAM QUESTIONS AND
ANSWERS. VERIFIED 2026.
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) - ANS Differential:
Generalized tonic-clonic seizure
Convulsive syncope
Substance abuse/overdose
Malingering
Hypoglycemia
Workup:
CBC
Electrolytes, glucose
Urine toxicology
EEG
MRI—brain
CT—head
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,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. -
ANS 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. - ANS Differential:
Orthostatic hypotension due to dehydration (diarrhea, diuretic use)
Vestibular neuronitis
Labyrinthitis
Benign positional vertigo
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,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. - ANS Differential:
Cardiac arrhythmia (causing syncope)
Severe aortic stenosis
Syncope (other causes)
Seizure
Pulmonary embolism
Workup:
ECG
Holter monitoring
CBC
Electrolytes, glucose
Echocardiography
CT—head
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, 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. - ANS Differential:
Pyloric stenosis
Partial duodenal atresia
GERD
Gastroenteritis
Hepatitis
UTI
Otitis media
Workup:
Physical exam
CBC
Electrolytes
U/S—abdomen
Barium swallow
pH probe
Endoscopy
AST/ALT/bilirubin/alkaline phosphatase
UA, urine culture
Tympanocentesis culture
Presentation:
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
CASES EXAM QUESTIONS AND
ANSWERS. VERIFIED 2026.
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) - ANS Differential:
Generalized tonic-clonic seizure
Convulsive syncope
Substance abuse/overdose
Malingering
Hypoglycemia
Workup:
CBC
Electrolytes, glucose
Urine toxicology
EEG
MRI—brain
CT—head
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,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. -
ANS 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. - ANS Differential:
Orthostatic hypotension due to dehydration (diarrhea, diuretic use)
Vestibular neuronitis
Labyrinthitis
Benign positional vertigo
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,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. - ANS Differential:
Cardiac arrhythmia (causing syncope)
Severe aortic stenosis
Syncope (other causes)
Seizure
Pulmonary embolism
Workup:
ECG
Holter monitoring
CBC
Electrolytes, glucose
Echocardiography
CT—head
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, 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. - ANS Differential:
Pyloric stenosis
Partial duodenal atresia
GERD
Gastroenteritis
Hepatitis
UTI
Otitis media
Workup:
Physical exam
CBC
Electrolytes
U/S—abdomen
Barium swallow
pH probe
Endoscopy
AST/ALT/bilirubin/alkaline phosphatase
UA, urine culture
Tympanocentesis culture
Presentation:
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
