USMLE Step 2 Rapid Review (With Complete solution)

Sawtooth" P waves - Classic ECG finding in atrial flutter. Angina is new, is worsening, or occurs at rest - Definition of unstable angina. ACEI - Antihypertensive for a diabetic patient with proteinuria. Hypotension, distant heart sounds, and JVD - Beck's triad for cardiac tamponade. β-blockers, digoxin, calcium channel blockers - Drugs that slow AV node transmission. Niacin - Hypercholesterolemia treatment that → flushing and pruritus. Anticoagulation, rate control, cardioversion - Treatment for atrial fibrillation. Immediate cardioversion - Treatment for ventricular fibrillation. Dressler's syndrome: fever, pericarditis, ↑ ESR - Autoimmune complication occurring 2-4 weeks post-MI. Treat existing heart failure and replace the tricuspid valve - IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment? Echocardiogram (showing thickened left ventricular wall and outflow obstruction) - Diagnostic test for hypertrophic cardiomyopathy. Pulsus paradoxus (seen in cardiac tamponade) - A fall in systolic BP of > 10 mmHg with inspiration.Low-voltage, diffuse ST-segment elevation - Classic ECG findings in pericarditis. BP > 140/90 on three separate occasions two weeks apart - Definition of hypertension. Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism - Eight surgically correctable causes of hypertension. Abdominal ultrasound and CT - Evaluation of a pulsatile abdominal mass and bruit. > 5.5 cm, rapidly enlarging, symptomatic, or ruptured - Indications for surgical repair of abdominal aortic aneurysm. Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin - Treatment for acute coronary syndrome. Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states - What is the metabolic syndrome? Exercise stress treadmill with ECG - Appropriate diagnostic test? ■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate. Pharmacologic stress test (e.g., dobutamine echo) - Appropriate diagnostic test? ■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina. Angina, ST-segment changes on ECG, or ↓ BP - Signs of active ischemia during stress testing