USMLE STEP 2 CK FINAL PAPER 2026
COMPLETE SOLVED QUESTIONS PRACTICE
REVISION PACK EXPERT REVIEW 400 ITEMS
◉ Fondaparinux.
Answer: Factor Xa inhibitor
Contraindicated in Liver failure
Indicated in Kidney Failure
◉ Conditions associated to ITP.
Answer: Lymphoma, leukemia, HIV, HCV, EBV, SLE, alcohol use,
chemotherapy
◉ lead poisoning.
Answer: Mild (5-44): no med, repeat levels & relocation
Moderate (45-69): DMSA
Severe (>70): Dimercaprol + EDTA if encephalopathy
◉ Sideroblastic anemia.
Answer: Basophilic stippling in peripheral smear
Ringed sideroblasts only in bone marrow
,◉ B12 deficiency.
Answer: MMA and homocysteine
◉ Folate deficiency.
Answer: Normal MMA and increased homocysteine
◉ Warm AIHA.
Answer: SLE, CLL, drugs
◉ Cold AIHA.
Answer: Mycoplasma, mononucleosis, walderstrom
macroglobulinemia
◉ Polycythemia vera.
Answer: Hydroxyurea IFN
Ruxolitinib (JAK inh.)
◉ acute leukemia.
Answer: >20% blast cells
◉ Pleural fluid in TB.
,Answer: Increased protein level (>4g/dL)
Increased lymphocytic leukocytosis
Decreased glucose levels
Decreased ph
Increased LDH levels (>500)
◉ Uncomplicated pleural effusion.
Answer: Negative culture and gram stain (no bacteria)
ph > 7.2
Glucose >60
WBC < 50.000
Management: ATB only
◉ Complicated Pleural Effusion or Empyema.
Answer: ph < 7.2
Glucose <60
WBC > 50.000
Negative gram stain and culture ( FN due to low concentration of
bacteria)
Management: chest tube + ATB
◉ Severe PCP.
, Answer: Prednisone if: PaO2 <70 mmHg or an A-a gradient > 35
◉ hyperlipidemia screening.
Answer: Men > 35 and older
Women > 45
All at Higher risk for CAD >20 years
Fasting samples
Repeat every 5 years
◉ Dyslipidemia.
Answer: Total cholesterol >200 mg/dl
LDL >130 mg/dl
HDL <40 mg/dl
triglicerides >150 mg/dl
◉ Hypertension screening.
Answer: Age >18 at every visit
Patients >60 years: >150/90 mmHg
Patients <60 years: >140/90 mmHg
Patients >18 years + CKD or diabetes: >140/90 mmHg
COMPLETE SOLVED QUESTIONS PRACTICE
REVISION PACK EXPERT REVIEW 400 ITEMS
◉ Fondaparinux.
Answer: Factor Xa inhibitor
Contraindicated in Liver failure
Indicated in Kidney Failure
◉ Conditions associated to ITP.
Answer: Lymphoma, leukemia, HIV, HCV, EBV, SLE, alcohol use,
chemotherapy
◉ lead poisoning.
Answer: Mild (5-44): no med, repeat levels & relocation
Moderate (45-69): DMSA
Severe (>70): Dimercaprol + EDTA if encephalopathy
◉ Sideroblastic anemia.
Answer: Basophilic stippling in peripheral smear
Ringed sideroblasts only in bone marrow
,◉ B12 deficiency.
Answer: MMA and homocysteine
◉ Folate deficiency.
Answer: Normal MMA and increased homocysteine
◉ Warm AIHA.
Answer: SLE, CLL, drugs
◉ Cold AIHA.
Answer: Mycoplasma, mononucleosis, walderstrom
macroglobulinemia
◉ Polycythemia vera.
Answer: Hydroxyurea IFN
Ruxolitinib (JAK inh.)
◉ acute leukemia.
Answer: >20% blast cells
◉ Pleural fluid in TB.
,Answer: Increased protein level (>4g/dL)
Increased lymphocytic leukocytosis
Decreased glucose levels
Decreased ph
Increased LDH levels (>500)
◉ Uncomplicated pleural effusion.
Answer: Negative culture and gram stain (no bacteria)
ph > 7.2
Glucose >60
WBC < 50.000
Management: ATB only
◉ Complicated Pleural Effusion or Empyema.
Answer: ph < 7.2
Glucose <60
WBC > 50.000
Negative gram stain and culture ( FN due to low concentration of
bacteria)
Management: chest tube + ATB
◉ Severe PCP.
, Answer: Prednisone if: PaO2 <70 mmHg or an A-a gradient > 35
◉ hyperlipidemia screening.
Answer: Men > 35 and older
Women > 45
All at Higher risk for CAD >20 years
Fasting samples
Repeat every 5 years
◉ Dyslipidemia.
Answer: Total cholesterol >200 mg/dl
LDL >130 mg/dl
HDL <40 mg/dl
triglicerides >150 mg/dl
◉ Hypertension screening.
Answer: Age >18 at every visit
Patients >60 years: >150/90 mmHg
Patients <60 years: >140/90 mmHg
Patients >18 years + CKD or diabetes: >140/90 mmHg
