USMLE Step 2 CK (With Complete Solution)

Argatroban - Direct thrombin inhibitor Contraindicated in Renal Insuficiency Indicated in Liver Disease Fondaparinux - Factor Xa inhibitor Contraindicated in Liver failure Indicated in Kidney Failure Conditions associated to ITP - Lymphoma, leukemia, HIV, HCV, EBV, SLE, alcohol use, chemotherapy lead poisoning - Mild (5-44): no med, repeat levels & relocation Moderate (45-69): DMSA Severe (>70): Dimercaprol + EDTA if encephalopathy Sideroblastic anemia - Basophilic stippling in peripheral smear Ringed sideroblasts only in bone marrow B12 deficiency - MMA and homocysteine Folate deficiency - Normal MMA and increased homocysteine Warm AIHA - SLE, CLL, drugs Cold AIHA - Mycoplasma, mononucleosis, walderstrom macroglobulinemiaPolycythemia vera - Hydroxyurea IFN Ruxolitinib (JAK inh.) acute leukemia - >20% blast cells Pleural fluid in TB - Increased protein level (>4g/dL) Increased lymphocytic leukocytosis Decreased glucose levels Decreased ph Increased LDH levels (>500) Uncomplicated pleural effusion - Negative culture and gram stain (no bacteria) ph > 7.2 Glucose >60 WBC < 50.000 Management: ATB only Complicated Pleural Effusion or Empyema - 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 - Prednisone if: PaO2 <70 mmHg or an A-a gradient > 35 hyperlipidemia screening - Men > 35 and older