USMLE STEP 2 CK HIGH EXAM GUIDE
2024 WITH COMPLETE SOLUTION, Exams
of Nursing
aortic regurgitation Correct Answer early diastolic (mild) to
holodiastolic (severe) murmur. Bounding pulses. Tx- decrease
afterload with DHP Ca-channel blockers, ACEi, NOT beta
blockers.
mycoplasma PNA Correct Answer erythema multiforme. No cell
wall so not on gram stain
candidal vulvovaginitis Correct Answer pseudohyphae. In IMCD
and Abx treated people. Tx- oral fluconazole, topical nystatin
nonseminomatous germ cell tumor Correct Answer large anterior
mediastinal mass, young males. High HCG and AFP.
seminoma Correct Answer high HCG but normal AFP
thymoma Correct Answer associated with myasthenia gravis,
pemphigus
hepatocellular carcinoma Correct Answer high AFP but normal
HCG
choriocarcinoma Correct Answer gestational trophoblastic
disease usually in molar pregnancy. Very high HCG
C. dif diagnosis Correct Answer cytotoxin assay of stool
Erb-Duchenne palsy Correct Answer C5, C6. waiter's tip, absent
Moro but intact grasp
,Klumpke's paralysis Correct Answer C7, C8, T1. hand paralysis,
Horner's (ptosis, miosis)
dermatitis herpetiformis Correct Answer papulovesicular, pruritic.
Associated with Celiac. Dx - IgA anti-endomysial Ab, anti-gliadin
phenelzine Correct Answer MAOi antidepressant. Avoid
tyramine (aged meat/cheese) --> HTN crisis
CMV esophagitis Correct Answer in HIV. Dysphagia,
odynophagia, shallow ulcers, intranuclear/cytoplasmic inclusions.
Tx- ganciclovir IV
HSV esophagitis Correct Answer in HIV. Small ulcers with
volcano-like appearnace. Eosinophilic intranuclear inclusions. Tx-
acyclovir
candidal esophagitis Correct Answer most common HIV
esophagitis. Tx - oral fluconazole
splenic rupture Correct Answer ex-lap if unstable. CT if stable
pseudocyesis Correct Answer pregnancy conversion disorder
prolactin Correct Answer stimulated by serotonin and TRH,
inhibited by dopamine. Hypothyroid --> amenorrhea/galactorrhea
adenomyosis Correct Answer endometrial glands in
myometrium. Usually > 40yo, dysmenorrhea, menorrhagia,
enlarged symmetric uterus. Must curettage to r/o endometrial
carcinoma
leiomyoma/fibroids Correct Answer irregular shaped uterus
,endometriosis Correct Answer uterus not enlarged.
Dysmenorrhea, dyspareunia, dyschezia. Dx- laparoscopy. Tx-
OCPs
aminoglycosides Correct Answer amikacin, gentamicin,
tobramicin. ototoxic, nephrotoxic. Gentamicin very ototoxic
hydroxychloroquine Correct Answer DMARD. Treats SLE. SE -
retinopathy/corneal damage (need q6month eye exams), GI,
hemolysis in G6PD
methotrexate SE Correct Answer DMARD. Inhibits folate
metabolism. Macrocytic anemia, GI, hepatotoxic, ILD, alopecia,
pancytopenia
premature ovarian failure Correct Answer low estrogen, high
FSH > LH, <40yo
hyperparathyroidism Correct Answer hypercalcemia - stones,
bones, groans, psyciatric overtones, polydipsia, polyuria.
pseudogout. Also sometimes HTN
low-grade (without mets) gastric MALT lymphoma Correct
Answer H pylori association. Tx- PPI, clarithromycin, amoxicillin
Jarisch-Herxheimer rxn Correct Answer primary/secondary
syphilis treated with penicillin --> spirochetes die --> immune
complexes --> looks like syphilis flare-up
INH SE Correct Answer hepatitis, peripheral neuropathy/ataxia
(give pyridoxine)
fanconi anemia Correct Answer pancytopenia, congenital
anomalies, presents 4-12yo. Autosomal recessive. Skin changes
, diamond-blackfan Correct Answer pure red cell aplasia,
congenital anomalies. Presents 3 months old. Tx - steroids,
possibly transfusion
transient erythroblastopenia of childhood Correct Answer RBC
aplasia. Presents 6mo - 5yo
psoriatic arthritis Correct Answer DIP, dactylitis. Tx- NSAID, anti-
TNF, methotrexate, NOT steroids
RA Correct Answer MCP, PIP, not DIP. Tx- methotrexate,
hydroxychloroquine, TNF inhibitors (infliximab, etanercept)
OA Correct Answer DIP
adjustment disorder Correct Answer within 3 months of event,
lasts < 6 months post-event. Tx- cognitive/psychodynamic
psychotherapy
cushing's Correct Answer high corticosteroids, central obesity,
DM, proximal muscle weakness, psychosis, thin skin, purple
striae, osteoporosis, hypokalemic alkalosis, secondary HTN
APML Correct Answer Tx- ATRA
CML Correct Answer leukocytosis, anemia, increased
granulocytic forms (PMNs, bands), leuk alk phosh low (high in
leukemoid reaction). Philadelphia chromosome, t(9:22), BCR-ABL
gene. Tx- tyrosine kinase inhibitors (imatinib). Usually > 50yo
McCune-Albright Correct Answer 3 P's - precocious puberty,
pigmentation (café-au-lait), polyostotic fibrous dysplasia.
Associated with other endocrine d/o's - hyperthyroid,
prolactinoma, growth hormone, cushing's
2024 WITH COMPLETE SOLUTION, Exams
of Nursing
aortic regurgitation Correct Answer early diastolic (mild) to
holodiastolic (severe) murmur. Bounding pulses. Tx- decrease
afterload with DHP Ca-channel blockers, ACEi, NOT beta
blockers.
mycoplasma PNA Correct Answer erythema multiforme. No cell
wall so not on gram stain
candidal vulvovaginitis Correct Answer pseudohyphae. In IMCD
and Abx treated people. Tx- oral fluconazole, topical nystatin
nonseminomatous germ cell tumor Correct Answer large anterior
mediastinal mass, young males. High HCG and AFP.
seminoma Correct Answer high HCG but normal AFP
thymoma Correct Answer associated with myasthenia gravis,
pemphigus
hepatocellular carcinoma Correct Answer high AFP but normal
HCG
choriocarcinoma Correct Answer gestational trophoblastic
disease usually in molar pregnancy. Very high HCG
C. dif diagnosis Correct Answer cytotoxin assay of stool
Erb-Duchenne palsy Correct Answer C5, C6. waiter's tip, absent
Moro but intact grasp
,Klumpke's paralysis Correct Answer C7, C8, T1. hand paralysis,
Horner's (ptosis, miosis)
dermatitis herpetiformis Correct Answer papulovesicular, pruritic.
Associated with Celiac. Dx - IgA anti-endomysial Ab, anti-gliadin
phenelzine Correct Answer MAOi antidepressant. Avoid
tyramine (aged meat/cheese) --> HTN crisis
CMV esophagitis Correct Answer in HIV. Dysphagia,
odynophagia, shallow ulcers, intranuclear/cytoplasmic inclusions.
Tx- ganciclovir IV
HSV esophagitis Correct Answer in HIV. Small ulcers with
volcano-like appearnace. Eosinophilic intranuclear inclusions. Tx-
acyclovir
candidal esophagitis Correct Answer most common HIV
esophagitis. Tx - oral fluconazole
splenic rupture Correct Answer ex-lap if unstable. CT if stable
pseudocyesis Correct Answer pregnancy conversion disorder
prolactin Correct Answer stimulated by serotonin and TRH,
inhibited by dopamine. Hypothyroid --> amenorrhea/galactorrhea
adenomyosis Correct Answer endometrial glands in
myometrium. Usually > 40yo, dysmenorrhea, menorrhagia,
enlarged symmetric uterus. Must curettage to r/o endometrial
carcinoma
leiomyoma/fibroids Correct Answer irregular shaped uterus
,endometriosis Correct Answer uterus not enlarged.
Dysmenorrhea, dyspareunia, dyschezia. Dx- laparoscopy. Tx-
OCPs
aminoglycosides Correct Answer amikacin, gentamicin,
tobramicin. ototoxic, nephrotoxic. Gentamicin very ototoxic
hydroxychloroquine Correct Answer DMARD. Treats SLE. SE -
retinopathy/corneal damage (need q6month eye exams), GI,
hemolysis in G6PD
methotrexate SE Correct Answer DMARD. Inhibits folate
metabolism. Macrocytic anemia, GI, hepatotoxic, ILD, alopecia,
pancytopenia
premature ovarian failure Correct Answer low estrogen, high
FSH > LH, <40yo
hyperparathyroidism Correct Answer hypercalcemia - stones,
bones, groans, psyciatric overtones, polydipsia, polyuria.
pseudogout. Also sometimes HTN
low-grade (without mets) gastric MALT lymphoma Correct
Answer H pylori association. Tx- PPI, clarithromycin, amoxicillin
Jarisch-Herxheimer rxn Correct Answer primary/secondary
syphilis treated with penicillin --> spirochetes die --> immune
complexes --> looks like syphilis flare-up
INH SE Correct Answer hepatitis, peripheral neuropathy/ataxia
(give pyridoxine)
fanconi anemia Correct Answer pancytopenia, congenital
anomalies, presents 4-12yo. Autosomal recessive. Skin changes
, diamond-blackfan Correct Answer pure red cell aplasia,
congenital anomalies. Presents 3 months old. Tx - steroids,
possibly transfusion
transient erythroblastopenia of childhood Correct Answer RBC
aplasia. Presents 6mo - 5yo
psoriatic arthritis Correct Answer DIP, dactylitis. Tx- NSAID, anti-
TNF, methotrexate, NOT steroids
RA Correct Answer MCP, PIP, not DIP. Tx- methotrexate,
hydroxychloroquine, TNF inhibitors (infliximab, etanercept)
OA Correct Answer DIP
adjustment disorder Correct Answer within 3 months of event,
lasts < 6 months post-event. Tx- cognitive/psychodynamic
psychotherapy
cushing's Correct Answer high corticosteroids, central obesity,
DM, proximal muscle weakness, psychosis, thin skin, purple
striae, osteoporosis, hypokalemic alkalosis, secondary HTN
APML Correct Answer Tx- ATRA
CML Correct Answer leukocytosis, anemia, increased
granulocytic forms (PMNs, bands), leuk alk phosh low (high in
leukemoid reaction). Philadelphia chromosome, t(9:22), BCR-ABL
gene. Tx- tyrosine kinase inhibitors (imatinib). Usually > 50yo
McCune-Albright Correct Answer 3 P's - precocious puberty,
pigmentation (café-au-lait), polyostotic fibrous dysplasia.
Associated with other endocrine d/o's - hyperthyroid,
prolactinoma, growth hormone, cushing's
