USMLE STEP 2 CK STUDY GUIDE,
EXAMS OF NURSING
What disease process does a direct Coombs test indicate?
Correct Answer Autoimmune anemia. IgG binds to RBC surface
and causes removal by RES of spleen.
An increase in BP that appears before 20 wks could be due to
what 2 disease processes? Correct Answer 1. Chronic HTN
2. Hydatiform mole
What causes breast milk jaundice? Correct Answer A factor in
human milk increases bilirubin enterohepatic circulation.
What is the time course of breast milk jaundice? Correct Answer
Starts after first 3-5 days of life, peaks within 1-2 weeks after birth
and can last several months.
What type of hyperbilirubinemia does breast milk jaundice cause?
Correct Answer Unconjugated hyperbilirubinemia.
What is the treatment for breast milk jaundice? Correct Answer
Temporarily interrupt breastfeeding if jaundice is severe,
otherwise, can continue breastfeeding.
What is breast feeding failure jaundice? Correct Answer Failure
to feed leading to insufficient caloric intake. "An exaggeration of
physiologic jaundice."
What is the time course of breast feeding failure jaundice?
Correct Answer First week of life.
What is the treatment for breast feeding failure jaundice? Correct
Answer Education about proper breast feeding methods.
,What percentage of birth weight is normally lost during the first
week of life? Correct Answer 10%
At what levels of bilirubinemia do you consider phototherapy in a
newborn? Correct Answer If otherwise healthy, 17-25 mg/dL
At what levels of bilirubinemia do you consider exchange
transfusion? Correct Answer > 25 mg/dL
What are three aspects of the history that distinguish between a
primary HIV infection and mononucleosis? Correct Answer Rash
and diarrhea is more common in HIV, tonsillar exudate
uncommon in HIV.
What are the si/sx of a bacterial vs a viral pharyngitis? Correct
Answer Bacterial: fever, painful cervical LAD, exudative
pharyngitis
Viral: conjunctivitis, rhinorrhea, viral exanthem.
When is labor preterm? Correct Answer < 37 weeks.
pH of vaginal secretions with candidiasis? Correct Answer 4-4.5
What gynecological diseases cause elevation of vaginal pH?
Correct Answer BV and trichomonas 5-6
What is the treatment of choice for Lyme disease in
pregnant/lactating women? Correct Answer Amoxicillin.
Azithromycin is not as effective. PCN G is an alternative.
A pituitary microadenoma is what size? Treatment in sx vs asx
pts? Correct Answer < 10 mm. Cabergoline is first line
(dopaminergic agent). Can observe in asx pts.
,What hemotologic lab finding might you see in a pt on MTX for
RA? Correct Answer Macrocytic anemia (MTX inhibits
dihydrofolate reductase)
At what level of K is considered hyperkalemia? Correct Answer
> 5.2 mmol/L
Immediate treatment for hyperkalemia is needed in what cases?
Correct Answer > 6.5, EKG changes, muscular paralysis,
What are some si/sx of androgen insensitivity syndrome? Correct
Answer Primary amenorrhea, bilateral inguinal masses, breast
development without pubic or axillary hair, blind vaginal pouch,
46XY.
When should a gonadectomy be performed in androgen
insensitivity syndrome? Correct Answer Upon completion of
puberty to avoid testicular carcinoma.
Indications for GBS ppx when the GBS status is unknown (4).
Correct Answer Delivery at < 37 wks
Duration of membrane rupture > or = to 18 hours
GBS bacteriuria in any concentration durign the current
pregnancy
Prior hx of delivery of an infant with GBS sepsis
In a pt with the most common form of CAH, what steroid will
accumulate? Correct Answer Pts with 21-hydroxylase deficiency
will have 17-alpha-hydroxyprogesterone levels.
What are Burr cells? Correct Answer Spiculated RBC of similar
size and with regularly spaced projectioins. Seen in uremia or with
preparation artifacts.
, What diagnositic test is indicated for evaluation of possible
esophageal rupture? Correct Answer Gastrografin-contrast
esophagography
What are the risk factors for CAD? Correct Answer male > or =
45, female > or = 55
HTN
Smoking
HDL < 40 mg/dL
Family history of premature CAD (male < 55, female < 65)
Note: having HDL > or = to 60 negates one risk factor.
What are some CAD risk equivalents? Correct Answer DM,
symptomatic carotid artery disease, AAA, PAD, or a 10-year risk
of CAD of 20% or greater.
What are the LDL Goals, LDL levels at which lifestyle modification
starts, and LDL levels at which drug therapy starts for a pt with 0-
1 risk factors? Correct Answer LDL Goal < 160 mg/dL
Life mod > or = to 160 mg/dL
Drugs > or = to 190 mg/dL
What are the LDL goals, LDL levels at which lifestyle modification
starts, LDL levels at which drug therapy starts for a pt with 2+
CAD risk factors? Correct Answer LDL goal <130
Life mod > or = 130
Drugs > or = 160
What are the LDL goals, LDL level at which lifestyle mod starts,
LDL level at which drug therapy starts for pt with CAD or CAD risk
equivalent? Correct Answer LDL goal < 100 mg/dL
Life mod > or = to 100 mg/dL
Drugs > or = to 130 mg/dL
EXAMS OF NURSING
What disease process does a direct Coombs test indicate?
Correct Answer Autoimmune anemia. IgG binds to RBC surface
and causes removal by RES of spleen.
An increase in BP that appears before 20 wks could be due to
what 2 disease processes? Correct Answer 1. Chronic HTN
2. Hydatiform mole
What causes breast milk jaundice? Correct Answer A factor in
human milk increases bilirubin enterohepatic circulation.
What is the time course of breast milk jaundice? Correct Answer
Starts after first 3-5 days of life, peaks within 1-2 weeks after birth
and can last several months.
What type of hyperbilirubinemia does breast milk jaundice cause?
Correct Answer Unconjugated hyperbilirubinemia.
What is the treatment for breast milk jaundice? Correct Answer
Temporarily interrupt breastfeeding if jaundice is severe,
otherwise, can continue breastfeeding.
What is breast feeding failure jaundice? Correct Answer Failure
to feed leading to insufficient caloric intake. "An exaggeration of
physiologic jaundice."
What is the time course of breast feeding failure jaundice?
Correct Answer First week of life.
What is the treatment for breast feeding failure jaundice? Correct
Answer Education about proper breast feeding methods.
,What percentage of birth weight is normally lost during the first
week of life? Correct Answer 10%
At what levels of bilirubinemia do you consider phototherapy in a
newborn? Correct Answer If otherwise healthy, 17-25 mg/dL
At what levels of bilirubinemia do you consider exchange
transfusion? Correct Answer > 25 mg/dL
What are three aspects of the history that distinguish between a
primary HIV infection and mononucleosis? Correct Answer Rash
and diarrhea is more common in HIV, tonsillar exudate
uncommon in HIV.
What are the si/sx of a bacterial vs a viral pharyngitis? Correct
Answer Bacterial: fever, painful cervical LAD, exudative
pharyngitis
Viral: conjunctivitis, rhinorrhea, viral exanthem.
When is labor preterm? Correct Answer < 37 weeks.
pH of vaginal secretions with candidiasis? Correct Answer 4-4.5
What gynecological diseases cause elevation of vaginal pH?
Correct Answer BV and trichomonas 5-6
What is the treatment of choice for Lyme disease in
pregnant/lactating women? Correct Answer Amoxicillin.
Azithromycin is not as effective. PCN G is an alternative.
A pituitary microadenoma is what size? Treatment in sx vs asx
pts? Correct Answer < 10 mm. Cabergoline is first line
(dopaminergic agent). Can observe in asx pts.
,What hemotologic lab finding might you see in a pt on MTX for
RA? Correct Answer Macrocytic anemia (MTX inhibits
dihydrofolate reductase)
At what level of K is considered hyperkalemia? Correct Answer
> 5.2 mmol/L
Immediate treatment for hyperkalemia is needed in what cases?
Correct Answer > 6.5, EKG changes, muscular paralysis,
What are some si/sx of androgen insensitivity syndrome? Correct
Answer Primary amenorrhea, bilateral inguinal masses, breast
development without pubic or axillary hair, blind vaginal pouch,
46XY.
When should a gonadectomy be performed in androgen
insensitivity syndrome? Correct Answer Upon completion of
puberty to avoid testicular carcinoma.
Indications for GBS ppx when the GBS status is unknown (4).
Correct Answer Delivery at < 37 wks
Duration of membrane rupture > or = to 18 hours
GBS bacteriuria in any concentration durign the current
pregnancy
Prior hx of delivery of an infant with GBS sepsis
In a pt with the most common form of CAH, what steroid will
accumulate? Correct Answer Pts with 21-hydroxylase deficiency
will have 17-alpha-hydroxyprogesterone levels.
What are Burr cells? Correct Answer Spiculated RBC of similar
size and with regularly spaced projectioins. Seen in uremia or with
preparation artifacts.
, What diagnositic test is indicated for evaluation of possible
esophageal rupture? Correct Answer Gastrografin-contrast
esophagography
What are the risk factors for CAD? Correct Answer male > or =
45, female > or = 55
HTN
Smoking
HDL < 40 mg/dL
Family history of premature CAD (male < 55, female < 65)
Note: having HDL > or = to 60 negates one risk factor.
What are some CAD risk equivalents? Correct Answer DM,
symptomatic carotid artery disease, AAA, PAD, or a 10-year risk
of CAD of 20% or greater.
What are the LDL Goals, LDL levels at which lifestyle modification
starts, and LDL levels at which drug therapy starts for a pt with 0-
1 risk factors? Correct Answer LDL Goal < 160 mg/dL
Life mod > or = to 160 mg/dL
Drugs > or = to 190 mg/dL
What are the LDL goals, LDL levels at which lifestyle modification
starts, LDL levels at which drug therapy starts for a pt with 2+
CAD risk factors? Correct Answer LDL goal <130
Life mod > or = 130
Drugs > or = 160
What are the LDL goals, LDL level at which lifestyle mod starts,
LDL level at which drug therapy starts for pt with CAD or CAD risk
equivalent? Correct Answer LDL goal < 100 mg/dL
Life mod > or = to 100 mg/dL
Drugs > or = to 130 mg/dL
