USMLE Step 2 CK Questions And Answers All
Are Correct Tests
Pregnant with active HBV Correct Answer: tx newborn with HBIG and HBV vaccine
Beck's triad for tamponade Correct Answer: hypotension, JVD, muffled heart sounds (also pulses
paradoxes). Electrical alternant
Subarachnoid hemorrhage Correct Answer: increased ADH and BNP --> hyponatremia. Tx - water
restriction
Coccidioidomycosis Correct Answer: SW US, central/south America. Palm infection - dry cough,
weight loss, pleuritic chest pain, erythema multiform/nod sum, arthralgia’s
Histoplasmosis Correct Answer: SE US, mid Atlantic, central US, caves. Acute PNA, but usually
asymptomatic. HIV disseminated infection- hilar LAD, pneumonitis, pancytopenia,
hepatosplenomegaly, palatal ulcers. Tx- IV amphotericin B followed by lifelong Iitraconazole.
Blast mycosis Correct Answer: central US (most in Wisconsin). Often asymptomatic or flu-like Six.
Systemic disease- lytic bone lesions, pulmonary infection, skin lesions. Ds- broad-based budding
yeast. Tx- Iitraconazole, amphotericin B
Aspergillosis Correct Answer: invasive in IMCD. CXR - cavity lesions. CT - palm nodules, halo sign,
air crescent
Sporotrichosis Correct Answer: subcutaneous infection. Gardeners. Travel up lymphatics for nodules
on forearms
Cryptococcus Correct Answer: pulm infection often asymptomatic. Usually meningoencephalitis in
HIV with CD4<200
Hemochromatosis infections Correct Answer: Listeria monocytogenes, Yersinia enterocolitica,
septicemia - Vibrio vulnificus
Narcolepsy treatment Correct Answer: methyldphenidate, modafinil, antidepressants (for cataplexy)
Galactorrhea Correct Answer: test B-HCG, prolactin, TSH
Septic abortion Correct Answer: cervical/blood cultures, antibiotics, gentle suction currettage
Lesch-Nyhan Correct Answer: x-linked recessive, HPRT deficiency, increased uric acid. Sx - self
mutilation, dystonia, spacticity, gout. Presents at 6 months.
Minimal change disease Correct Answer: tx - prednisone, cyclophosphamide for resistant
cases/frequent relapse
Sturge-Weber Correct Answer: seizures, retardation, trigeminal port-wine stain, hemi neuro findings,
tramline intracranial calcifications
,Tuberous sclerosis Correct Answer: seizures, retardation, intracranial calcifications (tubers), ashleaf
spots, adenoma sebaceum (red papules on face)
Osteogenesis imperfecta Correct Answer: autosomal dominant. Type 1 collagen problem. Type 2
most severe with perinatal fractures and often intrauterine death. Blue sclera, fractures, hypotonia,
hearing loss, joint hypermobility, dentinogenesis imperfecta
Polymyalgia rheumatica Correct Answer: neck/shoulder/hip pain/stiffness. >50 years old, high ESR.
Tx- low dose prednisone, high dose for temporal arteritis
Massive blood transfusion Correct Answer: citrate anticoagulant --> chelates Ca and Mg --> low Ca --
> paresthesias, hyperactive reflexes
Nephrotic syndrome Correct Answer: dyslipidemia, accelerated atherosclerosis, hypercoagulable, risk
for MI/stroke, higher infxn susceptibility. Can have renal vein thrombosis, usually with membranous
GN
Aortic regurgitation Correct Answer: early diastolic (mild) to holodiastolic (severe) murmur. Bounding
pulses. Tx- decrease afterload with DHP Ca-channel blockers, acei, NOT beta blockers.
Mycoplasma PNA Correct Answer: erythema multiforme. No cell wall so not on gram stain
Candidal vulvovaginitis Correct Answer: pseudohyphae. In IMCD and Abx treated people. Tx- oral
fluconazole, topical nystatin
Nonseminomatous germ cell tumor Correct Answer: large anterior mediastinal mass, young males.
High HCG and AFP.
Seminoma Correct Answer: high HCG but normal AFP
Thymoma Correct Answer: associated with myasthenia gravis, pemphigus
Hepatocellular carcinoma Correct Answer: high AFP but normal HCG
Choriocarcinoma Correct Answer: gestational trophoblastic disease usually in molar pregnancy. Very
high HCG
C. Dif diagnosis Correct Answer: cytotoxin assay of stool
Erb-Duchenne palsy Correct Answer: C5, C6. Waiter's tip, absent Moro but intact grasp
Klumpke's paralysis Correct Answer: C7, C8, T1. Hand paralysis, Horner's (ptosis, miosis)
Dermatitis herpetiformis Correct Answer: papulovesicular, pruritic. Associated with Celiac. Dx - iga
anti-endomysial Ab, anti-gliadin
Phenelzine Correct Answer: maoi antidepressant. Avoid tyramine (aged meat/cheese) --> HTN crisis
, CMV esophagitis Correct Answer: in HIV. Dysphagia, odynophagia, shallow ulcers,
intranuclear/cytoplasmic inclusions. Tx- ganciclovir IV
HSV esophagitis Correct Answer: in HIV. Small ulcers with volcano-like appearnace. Eosinophilic
intranuclear inclusions. Tx- acyclovir
Candidal esophagitis Correct Answer: most common HIV esophagitis. Tx - oral fluconazole
Splenic rupture Correct Answer: ex-lap if unstable. CT if stable
Pseudocyesis Correct Answer: pregnancy conversion disorder
Prolactin Correct Answer: stimulated by serotonin and TRH, inhibited by dopamine. Hypothyroid -->
amenorrhea/galactorrhea
Adenomyosis Correct Answer: endometrial glands in myometrium. Usually > 40yo, dysmenorrhea,
menorrhagia, enlarged symmetric uterus. Must curettage to r/o endometrial carcinoma
Leiomyoma/fibroids Correct Answer: irregular shaped uterus
Endometriosis Correct Answer: uterus not enlarged. Dysmenorrhea, dyspareunia, dyschezia. Dx-
laparoscopy. Tx- ocps
Aminoglycosides Correct Answer: amikacin, gentamicin, tobramicin. Ototoxic, nephrotoxic.
Gentamicin very ototoxic
Hydroxychloroquine Correct Answer: DMARD. Treats SLE. SE - retinopathy/corneal damage (need
q6month eye exams), GI, hemolysis in G6PD
Methotrexate SE Correct Answer: DMARD. Inhibits folate metabolism. Macrocytic anemia, GI,
hepatotoxic, ILD, alopecia, pancytopenia
Premature ovarian failure Correct Answer: low estrogen, high FSH > LH, <40yo
Hyperparathyroidism Correct Answer: hypercalcemia - stones, bones, groans, psyciatric overtones,
polydipsia, polyuria. Pseudogout. Also sometimes HTN
Low-grade (without mets) gastric MALT lymphoma Correct Answer: H pylori association. Tx- PPI,
clarithromycin, amoxicillin
Jarisch-Herxheimer rxn Correct Answer: primary/secondary syphilis treated with penicillin -->
spirochetes die --> immune complexes --> looks like syphilis flare-up
INH SE Correct Answer: hepatitis, peripheral neuropathy/ataxia (give pyridoxine)
Fanconi anemia Correct Answer: pancytopenia, congenital anomalies, presents 4-12yo. Autosomal
recessive. Skin changes
Diamond-blackfan Correct Answer: pure red cell aplasia, congenital anomalies. Presents 3 months
old. Tx - steroids, possibly transfusion
Are Correct Tests
Pregnant with active HBV Correct Answer: tx newborn with HBIG and HBV vaccine
Beck's triad for tamponade Correct Answer: hypotension, JVD, muffled heart sounds (also pulses
paradoxes). Electrical alternant
Subarachnoid hemorrhage Correct Answer: increased ADH and BNP --> hyponatremia. Tx - water
restriction
Coccidioidomycosis Correct Answer: SW US, central/south America. Palm infection - dry cough,
weight loss, pleuritic chest pain, erythema multiform/nod sum, arthralgia’s
Histoplasmosis Correct Answer: SE US, mid Atlantic, central US, caves. Acute PNA, but usually
asymptomatic. HIV disseminated infection- hilar LAD, pneumonitis, pancytopenia,
hepatosplenomegaly, palatal ulcers. Tx- IV amphotericin B followed by lifelong Iitraconazole.
Blast mycosis Correct Answer: central US (most in Wisconsin). Often asymptomatic or flu-like Six.
Systemic disease- lytic bone lesions, pulmonary infection, skin lesions. Ds- broad-based budding
yeast. Tx- Iitraconazole, amphotericin B
Aspergillosis Correct Answer: invasive in IMCD. CXR - cavity lesions. CT - palm nodules, halo sign,
air crescent
Sporotrichosis Correct Answer: subcutaneous infection. Gardeners. Travel up lymphatics for nodules
on forearms
Cryptococcus Correct Answer: pulm infection often asymptomatic. Usually meningoencephalitis in
HIV with CD4<200
Hemochromatosis infections Correct Answer: Listeria monocytogenes, Yersinia enterocolitica,
septicemia - Vibrio vulnificus
Narcolepsy treatment Correct Answer: methyldphenidate, modafinil, antidepressants (for cataplexy)
Galactorrhea Correct Answer: test B-HCG, prolactin, TSH
Septic abortion Correct Answer: cervical/blood cultures, antibiotics, gentle suction currettage
Lesch-Nyhan Correct Answer: x-linked recessive, HPRT deficiency, increased uric acid. Sx - self
mutilation, dystonia, spacticity, gout. Presents at 6 months.
Minimal change disease Correct Answer: tx - prednisone, cyclophosphamide for resistant
cases/frequent relapse
Sturge-Weber Correct Answer: seizures, retardation, trigeminal port-wine stain, hemi neuro findings,
tramline intracranial calcifications
,Tuberous sclerosis Correct Answer: seizures, retardation, intracranial calcifications (tubers), ashleaf
spots, adenoma sebaceum (red papules on face)
Osteogenesis imperfecta Correct Answer: autosomal dominant. Type 1 collagen problem. Type 2
most severe with perinatal fractures and often intrauterine death. Blue sclera, fractures, hypotonia,
hearing loss, joint hypermobility, dentinogenesis imperfecta
Polymyalgia rheumatica Correct Answer: neck/shoulder/hip pain/stiffness. >50 years old, high ESR.
Tx- low dose prednisone, high dose for temporal arteritis
Massive blood transfusion Correct Answer: citrate anticoagulant --> chelates Ca and Mg --> low Ca --
> paresthesias, hyperactive reflexes
Nephrotic syndrome Correct Answer: dyslipidemia, accelerated atherosclerosis, hypercoagulable, risk
for MI/stroke, higher infxn susceptibility. Can have renal vein thrombosis, usually with membranous
GN
Aortic regurgitation Correct Answer: early diastolic (mild) to holodiastolic (severe) murmur. Bounding
pulses. Tx- decrease afterload with DHP Ca-channel blockers, acei, NOT beta blockers.
Mycoplasma PNA Correct Answer: erythema multiforme. No cell wall so not on gram stain
Candidal vulvovaginitis Correct Answer: pseudohyphae. In IMCD and Abx treated people. Tx- oral
fluconazole, topical nystatin
Nonseminomatous germ cell tumor Correct Answer: large anterior mediastinal mass, young males.
High HCG and AFP.
Seminoma Correct Answer: high HCG but normal AFP
Thymoma Correct Answer: associated with myasthenia gravis, pemphigus
Hepatocellular carcinoma Correct Answer: high AFP but normal HCG
Choriocarcinoma Correct Answer: gestational trophoblastic disease usually in molar pregnancy. Very
high HCG
C. Dif diagnosis Correct Answer: cytotoxin assay of stool
Erb-Duchenne palsy Correct Answer: C5, C6. Waiter's tip, absent Moro but intact grasp
Klumpke's paralysis Correct Answer: C7, C8, T1. Hand paralysis, Horner's (ptosis, miosis)
Dermatitis herpetiformis Correct Answer: papulovesicular, pruritic. Associated with Celiac. Dx - iga
anti-endomysial Ab, anti-gliadin
Phenelzine Correct Answer: maoi antidepressant. Avoid tyramine (aged meat/cheese) --> HTN crisis
, CMV esophagitis Correct Answer: in HIV. Dysphagia, odynophagia, shallow ulcers,
intranuclear/cytoplasmic inclusions. Tx- ganciclovir IV
HSV esophagitis Correct Answer: in HIV. Small ulcers with volcano-like appearnace. Eosinophilic
intranuclear inclusions. Tx- acyclovir
Candidal esophagitis Correct Answer: most common HIV esophagitis. Tx - oral fluconazole
Splenic rupture Correct Answer: ex-lap if unstable. CT if stable
Pseudocyesis Correct Answer: pregnancy conversion disorder
Prolactin Correct Answer: stimulated by serotonin and TRH, inhibited by dopamine. Hypothyroid -->
amenorrhea/galactorrhea
Adenomyosis Correct Answer: endometrial glands in myometrium. Usually > 40yo, dysmenorrhea,
menorrhagia, enlarged symmetric uterus. Must curettage to r/o endometrial carcinoma
Leiomyoma/fibroids Correct Answer: irregular shaped uterus
Endometriosis Correct Answer: uterus not enlarged. Dysmenorrhea, dyspareunia, dyschezia. Dx-
laparoscopy. Tx- ocps
Aminoglycosides Correct Answer: amikacin, gentamicin, tobramicin. Ototoxic, nephrotoxic.
Gentamicin very ototoxic
Hydroxychloroquine Correct Answer: DMARD. Treats SLE. SE - retinopathy/corneal damage (need
q6month eye exams), GI, hemolysis in G6PD
Methotrexate SE Correct Answer: DMARD. Inhibits folate metabolism. Macrocytic anemia, GI,
hepatotoxic, ILD, alopecia, pancytopenia
Premature ovarian failure Correct Answer: low estrogen, high FSH > LH, <40yo
Hyperparathyroidism Correct Answer: hypercalcemia - stones, bones, groans, psyciatric overtones,
polydipsia, polyuria. Pseudogout. Also sometimes HTN
Low-grade (without mets) gastric MALT lymphoma Correct Answer: H pylori association. Tx- PPI,
clarithromycin, amoxicillin
Jarisch-Herxheimer rxn Correct Answer: primary/secondary syphilis treated with penicillin -->
spirochetes die --> immune complexes --> looks like syphilis flare-up
INH SE Correct Answer: hepatitis, peripheral neuropathy/ataxia (give pyridoxine)
Fanconi anemia Correct Answer: pancytopenia, congenital anomalies, presents 4-12yo. Autosomal
recessive. Skin changes
Diamond-blackfan Correct Answer: pure red cell aplasia, congenital anomalies. Presents 3 months
old. Tx - steroids, possibly transfusion
