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 pulsus
paradoxus). Electrical alternans
subarachnoid hemorrhage Correct Answer: increased ADH and BNP --> hyponatremia. Tx - water
restriction
coccidioidomycosis Correct Answer: SW US, central/south America. Pulm infection - dry cough, weight
loss, pleuritic chest pain, erythema multiforme/nodosum, arthralgias
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 itraconazole.
Blastomycosis Correct Answer: central US (most in Wisconsin). Often asymptomatic or flu-like Sx.
Systemic disease- lytic bone lesions, pulmonary infection, skin lesions. Dx- broad-based budding yeast.
Tx- itraconazole, amphotericin B
aspergillosis Correct Answer: invasive in IMCD. CXR - cavitary lesions. CT - pulm 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)
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 pulsus
paradoxus). Electrical alternans
subarachnoid hemorrhage Correct Answer: increased ADH and BNP --> hyponatremia. Tx - water
restriction
coccidioidomycosis Correct Answer: SW US, central/south America. Pulm infection - dry cough, weight
loss, pleuritic chest pain, erythema multiforme/nodosum, arthralgias
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 itraconazole.
Blastomycosis Correct Answer: central US (most in Wisconsin). Often asymptomatic or flu-like Sx.
Systemic disease- lytic bone lesions, pulmonary infection, skin lesions. Dx- broad-based budding yeast.
Tx- itraconazole, amphotericin B
aspergillosis Correct Answer: invasive in IMCD. CXR - cavitary lesions. CT - pulm 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)
