5:47:55 PM Thursday, July 31, 2025
USMLE Step 2 STUDY GUIDE
What are the diamond criteria for CAD? What is atypical angina?
1. Substernal CP
2. worse with exertion
3. relieved with NTG
atypical =2/3
Decreased feeding, hypothermia, lethargy in a 19d old, x 2 days?
What to use for treatment of woman with prior miscarriage who you suspect has
antiphospholipid syndrome?
SEPSIS, in a neonate, can have leukopenia or leukocytosis. Tx with amp and gent
LMWH
Waldenstrom's macroglobulinemia
B-cell lymphoma that produces monoclonal IgM(it's a BIG Ig), patients present with generalized
lymphadenopathy. There will be M-spike due to IgM. No lytic bone lesions. Causes serum
viscosity leading to defective platelet aggregation, and sausage link retinal changes due to
hyperviscosit, Treat with plasmaphoresis. Dx with SPEP
Membranoproliferative glomerulonephritis
"Tram-track" appearance of capillary loops of glomerular basement membranes on light
microscopy due to persistent activation of the alternative complement pathway and
intramembranous deposition of dense deposits.
DiGeorge Syndrome
Conotruncal defects, Abnormal facies, Thymus absent, Craniofacial defects and Cleft palate,
Hypocalcemia/HypoPTH
CATCH22
Maldevelopment of 3 and 4 pharyngeal pouches, fascial dysmorphia, cardiac shunt, lack of T-
cells, undeveloped paracortex
PTSD puts you at risk for developing what psych illness later on?
depression, SI
,5:47:55 PM Thursday, July 31, 2025
Pt with h/o mania has sx of MDD. How to treat this acutely?
Treatment for acute mania?
Quetiapine, or lurasidone, or lamotrigine, or valproate, or lithium
olanzapine
Best anticoagulants for patients with ESRD?
incision site is dehiscing, but fascia is intact. what to do?
UFH. not LMWH or the others
just dressing changes, as long as there aren't signs of infection.
Erhlichiosis manifestations
Tick-borne; fever, malaise, headache, nausea, vomiting, leukopenia, thrombocytopenia. No
jaundice or hemolysis !!
Active phase arrest.
btw what is the active phase?
what is active labor protraction? Tx?
no cervical change for 4 hours in setting of adequate (200) montevideo units OR no cerv change
for 6 hours with inadequate contraction --> indication for cesarean. Consider vacuum assist if
baby has made good progress but mom is now exhausted
Active= >6cm dilated, with reg ctx
<1cm cervical change/ 2hours. Tx with oxytocin
Acute PSGN can follow:
How to diagnose leprosy?
strep throat OR IMPETIGO
biopsy from the edge of the numb hypopigmented lesion
Erythema multiforme
Turbid green chest tube drainage after chest trauma?
, 5:47:55 PM Thursday, July 31, 2025
skin disorder resulting from a generalized allergic reaction to an illness, infection, or medication.
Ex: HSV, mycoplasma
esophageal perf
Disseminated MAC
Most common cause of an isolated, asymptomatic elevated alk phos?
Bone complication that RA patients are at risk for?
Fever, cough, abdominal pain, diarrhea, night sweats, weight loss
Splenomegaly
Elevated alk phos
Tx: prevention is azythromycin when CD4 <50
Paget's (osteitis deformans)
osteoporosis
Asthma exacerbation causes what pH disturbance?
Do not correct hyponatremia faster than:
respiratory acidosis. A metabolic alkalosis may develop in response. If, on blood gas, the pH
seems to be rising, they're likely crashing
0.5mEq/hr
In most congenital infections, you will see:
Uniquely rubella? CMV? syphilis? toxo?
jaundice, hepatosplenomegaly, blueberry muffin spots
Rubella: deafness
CMV: periventricular calcifications
syphilis: desquamating rash, rhinorrhea, weird bones and teeth and eyes
Toxo: chorioretinits, diffuse intracranial calcifications.
First line treatment for aortic dissection?
beta blockers!
USMLE Step 2 STUDY GUIDE
What are the diamond criteria for CAD? What is atypical angina?
1. Substernal CP
2. worse with exertion
3. relieved with NTG
atypical =2/3
Decreased feeding, hypothermia, lethargy in a 19d old, x 2 days?
What to use for treatment of woman with prior miscarriage who you suspect has
antiphospholipid syndrome?
SEPSIS, in a neonate, can have leukopenia or leukocytosis. Tx with amp and gent
LMWH
Waldenstrom's macroglobulinemia
B-cell lymphoma that produces monoclonal IgM(it's a BIG Ig), patients present with generalized
lymphadenopathy. There will be M-spike due to IgM. No lytic bone lesions. Causes serum
viscosity leading to defective platelet aggregation, and sausage link retinal changes due to
hyperviscosit, Treat with plasmaphoresis. Dx with SPEP
Membranoproliferative glomerulonephritis
"Tram-track" appearance of capillary loops of glomerular basement membranes on light
microscopy due to persistent activation of the alternative complement pathway and
intramembranous deposition of dense deposits.
DiGeorge Syndrome
Conotruncal defects, Abnormal facies, Thymus absent, Craniofacial defects and Cleft palate,
Hypocalcemia/HypoPTH
CATCH22
Maldevelopment of 3 and 4 pharyngeal pouches, fascial dysmorphia, cardiac shunt, lack of T-
cells, undeveloped paracortex
PTSD puts you at risk for developing what psych illness later on?
depression, SI
,5:47:55 PM Thursday, July 31, 2025
Pt with h/o mania has sx of MDD. How to treat this acutely?
Treatment for acute mania?
Quetiapine, or lurasidone, or lamotrigine, or valproate, or lithium
olanzapine
Best anticoagulants for patients with ESRD?
incision site is dehiscing, but fascia is intact. what to do?
UFH. not LMWH or the others
just dressing changes, as long as there aren't signs of infection.
Erhlichiosis manifestations
Tick-borne; fever, malaise, headache, nausea, vomiting, leukopenia, thrombocytopenia. No
jaundice or hemolysis !!
Active phase arrest.
btw what is the active phase?
what is active labor protraction? Tx?
no cervical change for 4 hours in setting of adequate (200) montevideo units OR no cerv change
for 6 hours with inadequate contraction --> indication for cesarean. Consider vacuum assist if
baby has made good progress but mom is now exhausted
Active= >6cm dilated, with reg ctx
<1cm cervical change/ 2hours. Tx with oxytocin
Acute PSGN can follow:
How to diagnose leprosy?
strep throat OR IMPETIGO
biopsy from the edge of the numb hypopigmented lesion
Erythema multiforme
Turbid green chest tube drainage after chest trauma?
, 5:47:55 PM Thursday, July 31, 2025
skin disorder resulting from a generalized allergic reaction to an illness, infection, or medication.
Ex: HSV, mycoplasma
esophageal perf
Disseminated MAC
Most common cause of an isolated, asymptomatic elevated alk phos?
Bone complication that RA patients are at risk for?
Fever, cough, abdominal pain, diarrhea, night sweats, weight loss
Splenomegaly
Elevated alk phos
Tx: prevention is azythromycin when CD4 <50
Paget's (osteitis deformans)
osteoporosis
Asthma exacerbation causes what pH disturbance?
Do not correct hyponatremia faster than:
respiratory acidosis. A metabolic alkalosis may develop in response. If, on blood gas, the pH
seems to be rising, they're likely crashing
0.5mEq/hr
In most congenital infections, you will see:
Uniquely rubella? CMV? syphilis? toxo?
jaundice, hepatosplenomegaly, blueberry muffin spots
Rubella: deafness
CMV: periventricular calcifications
syphilis: desquamating rash, rhinorrhea, weird bones and teeth and eyes
Toxo: chorioretinits, diffuse intracranial calcifications.
First line treatment for aortic dissection?
beta blockers!
