USMLE Step 2 Rapid Review With Complete Solution
"Sawtooth" P waves - ANSWER-Classic ECG finding in atrial flutter.
Angina is new, is worsening, or occurs at rest - ANSWER-Definition of unstable angina.
ACEI - ANSWER-Antihypertensive for a diabetic patient with proteinuria.
Hypotension, distant heart sounds, and JVD - ANSWER-Beck's triad for cardiac tamponade.
β-blockers, digoxin, calcium channel blockers - ANSWER-Drugs that slow AV node transmission.
Niacin - ANSWER-Hypercholesterolemia treatment that → flushing and pruritus.
Anticoagulation, rate control, cardioversion - ANSWER-Treatment for atrial fibrillation.
Immediate cardioversion - ANSWER-Treatment for ventricular fibrillation.
Dressler's syndrome: fever, pericarditis, ↑ ESR - ANSWER-Autoimmune complication occurring 2-4
weeks post-MI.
Treat existing heart failure and replace the tricuspid valve - ANSWER-IV drug use with JVD and
holosystolic murmur at the left sternal border. Treatment?
Echocardiogram (showing thickened left ventricular wall and outflow obstruction) - ANSWER-
Diagnostic test for hypertrophic cardiomyopathy.
Pulsus paradoxus (seen in cardiac tamponade) - ANSWER-A fall in systolic BP of > 10 mmHg with
inspiration.
Low-voltage, diffuse ST-segment elevation - ANSWER-Classic ECG findings in pericarditis.
BP > 140/90 on three separate occasions two weeks apart - ANSWER-Definition of hypertension.
Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's
syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism - ANSWER-
Eight surgically correctable causes of hypertension.
Abdominal ultrasound and CT - ANSWER-Evaluation of a pulsatile abdominal mass and bruit.
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured - ANSWER-Indications for surgical repair of
abdominal aortic aneurysm.
Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin - ANSWER-Treatment for acute
coronary syndrome.
Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or
proinflammatory states - ANSWER-What is the metabolic syndrome?
,Exercise stress treadmill with ECG - ANSWER-Appropriate diagnostic test? ■ A 50-year-old male with
angina can exercise to 85% of maximum predicted heart rate.
Pharmacologic stress test (e.g., dobutamine echo) - ANSWER-Appropriate diagnostic test? ■ A 65-
year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.
Angina, ST-segment changes on ECG, or ↓ BP - ANSWER-Signs of active ischemia during stress testing.
ST-segment elevation (depression means ischemia), flattened T waves, and Q waves - ANSWER-ECG
findings suggesting MI.
Prinzmetal's angina - ANSWER-A young patient has angina at rest with ST-segment elevation. Cardiac
enzymes are normal.
CHF, shock, and altered mental status - ANSWER-Common symptoms associated with silent MIs.
V/Q scan - ANSWER-The diagnostic test for pulmonary embolism.
Protamine - ANSWER-An agent that reverses the effects of heparin.
PT - ANSWER-The coagulation parameter affected by warfarin.
Hypertrophic cardiomyopathy - ANSWER-A young patient with a family history of sudden death
collapses and dies while exercising.
Oral surgery—amoxicillin; GI or GU procedures—ampicillin and gentamicin before and amoxicillin
after - ANSWER-Endocarditis prophylaxis regimens.
Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia - ANSWER-The 6 P's of ischemia due
to peripheral vascular disease.
Stasis, hypercoagulability, endothelial damage - ANSWER-Virchow's triad.
OCPs - ANSWER-The most common cause of hypertension in young women.
Excessive EtOH - ANSWER-The most common cause of hypertension in young men.
Seborrheic keratosis - ANSWER-"Stuck-on" appearance.
Psoriasis - ANSWER-Red plaques with silvery-white scales and sharp margins.
Basal cell carcinoma - ANSWER-The most common type of skin cancer; the lesion is a pearly-colored
papule with a translucent surface and telangiectasias.
Impetigo - ANSWER-Honey-crusted lesions.
Cellulitis - ANSWER-A febrile patient with a history of diabetes presents with a red, swollen, painful
lower extremity.
Pemphigus vulgaris - ANSWER-+ Nikolsky's sign.
Bullous pemphigoid - ANSWER-- Nikolsky's sign.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes - ANSWER-A 55-year-old obese
patient presents with dirty, velvety patches on the back of the neck.
Varicella zoster - ANSWER-Dermatomal distribution.
, Lichen planus - ANSWER-Flat-topped papules.
Erythema multiforme - ANSWER-Iris-like target lesions.
Contact dermatitis - ANSWER-A lesion characteristically occurring in a linear pattern in areas where
skin comes into contact with clothing or jewelry.
Pityriasis rosea - ANSWER-Presents with a herald patch, Christmas-tree pattern.
Alopecia areata (autoimmune process) - ANSWER-A 16-year-old presents with an annular patch of
alopecia with broken-off, stubby hairs.
Pityriasis versicolor - ANSWER-Pinkish, scaling, flat lesions on the chest and back. KOH prep has a
"spaghetti-and-meatballs" appearance.
Asymmetry, border irregularity, color variation, large diameter - ANSWER-Four characteristics of a
nevus suggestive of melanoma.
Actinic keratosis - ANSWER-Premalignant lesion from sun exposure that can → squamous cell
carcinoma.
Lesions of 1° varicella - ANSWER-"Dewdrop on a rose petal."
Seborrheic dermatitis. Treat with antifungals - ANSWER-"Cradle cap."
Acne vulgaris - ANSWER-Associated with Propionibacterium acnes and changes in androgen levels.
Herpes simplex - ANSWER-A painful, recurrent vesicular eruption of mucocutaneous surfaces.
Lichen sclerosus - ANSWER-Inflammation and epithelial thinning of the anogenital area,
predominantly in postmenopausal women.
Squamous cell carcinoma - ANSWER-Exophytic nodules on the skin with varying degrees of scaling or
ulceration; the second most common type of skin cancer.
Hashimoto's thyroiditis - ANSWER-The most common cause of hypothyroidism.
High TSH, low T4, antimicrosomal antibodies - ANSWER-Lab findings in Hashimoto's thyroiditis.
Graves' disease - ANSWER-Exophthalmos, pretibial myxedema, and ↓ TSH.
Iatrogenic steroid administration. The second most common cause is Cushing's disease - ANSWER-The
most common cause of Cushing's syndrome.
Hypoparathyroidism - ANSWER-A patient presents with signs of hypocalcemia, high phosphorus, and
low PTH.
Signs and symptoms of hypercalcemia - ANSWER-"Stones, bones, groans, psychiatric overtones."
1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia) - ANSWER-A patient
complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals
hypernatremia, hypokalemia, and metabolic alkalosis.
Pheochromocytoma - ANSWER-A patient presents with tachycardia, wild swings in BP, headache,
diaphoresis, altered mental status, and a sense of panic.
"Sawtooth" P waves - ANSWER-Classic ECG finding in atrial flutter.
Angina is new, is worsening, or occurs at rest - ANSWER-Definition of unstable angina.
ACEI - ANSWER-Antihypertensive for a diabetic patient with proteinuria.
Hypotension, distant heart sounds, and JVD - ANSWER-Beck's triad for cardiac tamponade.
β-blockers, digoxin, calcium channel blockers - ANSWER-Drugs that slow AV node transmission.
Niacin - ANSWER-Hypercholesterolemia treatment that → flushing and pruritus.
Anticoagulation, rate control, cardioversion - ANSWER-Treatment for atrial fibrillation.
Immediate cardioversion - ANSWER-Treatment for ventricular fibrillation.
Dressler's syndrome: fever, pericarditis, ↑ ESR - ANSWER-Autoimmune complication occurring 2-4
weeks post-MI.
Treat existing heart failure and replace the tricuspid valve - ANSWER-IV drug use with JVD and
holosystolic murmur at the left sternal border. Treatment?
Echocardiogram (showing thickened left ventricular wall and outflow obstruction) - ANSWER-
Diagnostic test for hypertrophic cardiomyopathy.
Pulsus paradoxus (seen in cardiac tamponade) - ANSWER-A fall in systolic BP of > 10 mmHg with
inspiration.
Low-voltage, diffuse ST-segment elevation - ANSWER-Classic ECG findings in pericarditis.
BP > 140/90 on three separate occasions two weeks apart - ANSWER-Definition of hypertension.
Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's
syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism - ANSWER-
Eight surgically correctable causes of hypertension.
Abdominal ultrasound and CT - ANSWER-Evaluation of a pulsatile abdominal mass and bruit.
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured - ANSWER-Indications for surgical repair of
abdominal aortic aneurysm.
Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin - ANSWER-Treatment for acute
coronary syndrome.
Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or
proinflammatory states - ANSWER-What is the metabolic syndrome?
,Exercise stress treadmill with ECG - ANSWER-Appropriate diagnostic test? ■ A 50-year-old male with
angina can exercise to 85% of maximum predicted heart rate.
Pharmacologic stress test (e.g., dobutamine echo) - ANSWER-Appropriate diagnostic test? ■ A 65-
year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.
Angina, ST-segment changes on ECG, or ↓ BP - ANSWER-Signs of active ischemia during stress testing.
ST-segment elevation (depression means ischemia), flattened T waves, and Q waves - ANSWER-ECG
findings suggesting MI.
Prinzmetal's angina - ANSWER-A young patient has angina at rest with ST-segment elevation. Cardiac
enzymes are normal.
CHF, shock, and altered mental status - ANSWER-Common symptoms associated with silent MIs.
V/Q scan - ANSWER-The diagnostic test for pulmonary embolism.
Protamine - ANSWER-An agent that reverses the effects of heparin.
PT - ANSWER-The coagulation parameter affected by warfarin.
Hypertrophic cardiomyopathy - ANSWER-A young patient with a family history of sudden death
collapses and dies while exercising.
Oral surgery—amoxicillin; GI or GU procedures—ampicillin and gentamicin before and amoxicillin
after - ANSWER-Endocarditis prophylaxis regimens.
Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia - ANSWER-The 6 P's of ischemia due
to peripheral vascular disease.
Stasis, hypercoagulability, endothelial damage - ANSWER-Virchow's triad.
OCPs - ANSWER-The most common cause of hypertension in young women.
Excessive EtOH - ANSWER-The most common cause of hypertension in young men.
Seborrheic keratosis - ANSWER-"Stuck-on" appearance.
Psoriasis - ANSWER-Red plaques with silvery-white scales and sharp margins.
Basal cell carcinoma - ANSWER-The most common type of skin cancer; the lesion is a pearly-colored
papule with a translucent surface and telangiectasias.
Impetigo - ANSWER-Honey-crusted lesions.
Cellulitis - ANSWER-A febrile patient with a history of diabetes presents with a red, swollen, painful
lower extremity.
Pemphigus vulgaris - ANSWER-+ Nikolsky's sign.
Bullous pemphigoid - ANSWER-- Nikolsky's sign.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes - ANSWER-A 55-year-old obese
patient presents with dirty, velvety patches on the back of the neck.
Varicella zoster - ANSWER-Dermatomal distribution.
, Lichen planus - ANSWER-Flat-topped papules.
Erythema multiforme - ANSWER-Iris-like target lesions.
Contact dermatitis - ANSWER-A lesion characteristically occurring in a linear pattern in areas where
skin comes into contact with clothing or jewelry.
Pityriasis rosea - ANSWER-Presents with a herald patch, Christmas-tree pattern.
Alopecia areata (autoimmune process) - ANSWER-A 16-year-old presents with an annular patch of
alopecia with broken-off, stubby hairs.
Pityriasis versicolor - ANSWER-Pinkish, scaling, flat lesions on the chest and back. KOH prep has a
"spaghetti-and-meatballs" appearance.
Asymmetry, border irregularity, color variation, large diameter - ANSWER-Four characteristics of a
nevus suggestive of melanoma.
Actinic keratosis - ANSWER-Premalignant lesion from sun exposure that can → squamous cell
carcinoma.
Lesions of 1° varicella - ANSWER-"Dewdrop on a rose petal."
Seborrheic dermatitis. Treat with antifungals - ANSWER-"Cradle cap."
Acne vulgaris - ANSWER-Associated with Propionibacterium acnes and changes in androgen levels.
Herpes simplex - ANSWER-A painful, recurrent vesicular eruption of mucocutaneous surfaces.
Lichen sclerosus - ANSWER-Inflammation and epithelial thinning of the anogenital area,
predominantly in postmenopausal women.
Squamous cell carcinoma - ANSWER-Exophytic nodules on the skin with varying degrees of scaling or
ulceration; the second most common type of skin cancer.
Hashimoto's thyroiditis - ANSWER-The most common cause of hypothyroidism.
High TSH, low T4, antimicrosomal antibodies - ANSWER-Lab findings in Hashimoto's thyroiditis.
Graves' disease - ANSWER-Exophthalmos, pretibial myxedema, and ↓ TSH.
Iatrogenic steroid administration. The second most common cause is Cushing's disease - ANSWER-The
most common cause of Cushing's syndrome.
Hypoparathyroidism - ANSWER-A patient presents with signs of hypocalcemia, high phosphorus, and
low PTH.
Signs and symptoms of hypercalcemia - ANSWER-"Stones, bones, groans, psychiatric overtones."
1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia) - ANSWER-A patient
complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals
hypernatremia, hypokalemia, and metabolic alkalosis.
Pheochromocytoma - ANSWER-A patient presents with tachycardia, wild swings in BP, headache,
diaphoresis, altered mental status, and a sense of panic.
