USMLE STEP 2 CK HIGH-YIELD STUDY GUIDE
QUESTIONS AND ANSWERS LATEST 2025-2026
EXAM UPDATE
Pulsus paradoxus - Answer-A decrease in systolic BP of > 10 mmHg
with inspiration; seen in cardiac tamponade
Classic ECG finding in pericarditis - Answer-Low-voltage, diffuse ST-
segment elevation
Definition of hypertension - Answer-BP > 140/90 on 3 separate
occasions 2 weeks apart
Eight surgically correctable causes of HTN - Answer-Renal artery
stenosis, coarc of aorta, pheo, Conn's, Cushing's syndrome, unilateral
renal parenchymal dz, hyperthyroid, hyperparathyroid
Evaluation of pulsatile abdominal mass and bruit - Answer-Abdominal
U/S and CT
Indications for surgical repair of abdominal aortic aneurysm - Answer-
>5.5cm, rapidly enlarging, symptomatic, ruptured
, Treatment for acute coronary syndrome - Answer-ASA, heparin,
clopidogrel, morphine, oxygen, sublingual nitro, IV beta-blockers
Metabolic syndrome - Answer-Abdominal obesity, high triglycerides,
low HDL, hypertension, insulin resistance, prothrombotic or
proinflammatory states
Appropriate diagnostic test: 50yo male with stable angina can exercise
to 85% of maximum predicted heart rate - Answer-Exercise stress
treadmill with ECG
Appropriate diagnostic test: 65yo female with LBBB and severe OA has
unstable angina - Answer-Pharmacologic stress test (e.g. dobutamine
echo)
Target LDL in a patient with diabetes - Answer-<70mg/dL
Signs of active ischemia during stress testing - Answer-Angina, ST-
segment changes on ECG or decreased BP
ECG findings suggestive of MI - Answer-ST-segment elevation
(depression means ischemia), flattened T waves, Q waves
Coronary territories in MI - Answer-Anterior wall (LAD/diagonal),
inferior (PDA), posterior (left circumflex/oblique, RCA/marginal),
septum (LAD/diagonal)
,A young patient with angina at rest and ST-segment elevation with
normal cardiac enzymes - Answer-Prinzmetal's angina
Common symptoms associated with silent MIs - Answer-CHF, shock,
AMS
Diagnostic test for PE - Answer-Spiral CT with contrast
Protamine - Answer-Reverses effects of heparin
Prothrombin time - Answer-Coagulation paramter affected by warfarin
A young patient with FHx of sudden death collapses and dies while
exercising - Answer-Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens - Answer-Oral surgery - amoxicillin
for certain situations; GI or GU procedures - not recommended
Virchow's triad - Answer-Stasis, hypercoagulability, endothelial
damage
The most common cause of HTN in young women - Answer-OCPs
, The most common cause of HTN in young men - Answer-Excessive
EtOH
Figure 3 sign - Answer-Aortic coarctation
Water-bottle shaped heart - Answer-Pericardial effusion, look for pulsus
paradoxus
"Stuck-on" appearance - Answer-Seborrheic keratosis
Red plaques with silvery-white scales and sharp margins - Answer-
Psoriasis
The most common type of skin cancer; lesion is pearly-colored papule
with translucent surface and telangiectasias - Answer-Basal cell
carcinoma
Honey-crusted lesions - Answer-Impetigo
A febrile patient with h/o diabetes presents with red, swollen, painful
lower extremity - Answer-Cellulitis
Positive Nikolsky's sign - Answer-Pemphigus vulgaris
Negative Nikolsky's sign - Answer-Bullous pemphigoid
QUESTIONS AND ANSWERS LATEST 2025-2026
EXAM UPDATE
Pulsus paradoxus - Answer-A decrease in systolic BP of > 10 mmHg
with inspiration; seen in cardiac tamponade
Classic ECG finding in pericarditis - Answer-Low-voltage, diffuse ST-
segment elevation
Definition of hypertension - Answer-BP > 140/90 on 3 separate
occasions 2 weeks apart
Eight surgically correctable causes of HTN - Answer-Renal artery
stenosis, coarc of aorta, pheo, Conn's, Cushing's syndrome, unilateral
renal parenchymal dz, hyperthyroid, hyperparathyroid
Evaluation of pulsatile abdominal mass and bruit - Answer-Abdominal
U/S and CT
Indications for surgical repair of abdominal aortic aneurysm - Answer-
>5.5cm, rapidly enlarging, symptomatic, ruptured
, Treatment for acute coronary syndrome - Answer-ASA, heparin,
clopidogrel, morphine, oxygen, sublingual nitro, IV beta-blockers
Metabolic syndrome - Answer-Abdominal obesity, high triglycerides,
low HDL, hypertension, insulin resistance, prothrombotic or
proinflammatory states
Appropriate diagnostic test: 50yo male with stable angina can exercise
to 85% of maximum predicted heart rate - Answer-Exercise stress
treadmill with ECG
Appropriate diagnostic test: 65yo female with LBBB and severe OA has
unstable angina - Answer-Pharmacologic stress test (e.g. dobutamine
echo)
Target LDL in a patient with diabetes - Answer-<70mg/dL
Signs of active ischemia during stress testing - Answer-Angina, ST-
segment changes on ECG or decreased BP
ECG findings suggestive of MI - Answer-ST-segment elevation
(depression means ischemia), flattened T waves, Q waves
Coronary territories in MI - Answer-Anterior wall (LAD/diagonal),
inferior (PDA), posterior (left circumflex/oblique, RCA/marginal),
septum (LAD/diagonal)
,A young patient with angina at rest and ST-segment elevation with
normal cardiac enzymes - Answer-Prinzmetal's angina
Common symptoms associated with silent MIs - Answer-CHF, shock,
AMS
Diagnostic test for PE - Answer-Spiral CT with contrast
Protamine - Answer-Reverses effects of heparin
Prothrombin time - Answer-Coagulation paramter affected by warfarin
A young patient with FHx of sudden death collapses and dies while
exercising - Answer-Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens - Answer-Oral surgery - amoxicillin
for certain situations; GI or GU procedures - not recommended
Virchow's triad - Answer-Stasis, hypercoagulability, endothelial
damage
The most common cause of HTN in young women - Answer-OCPs
, The most common cause of HTN in young men - Answer-Excessive
EtOH
Figure 3 sign - Answer-Aortic coarctation
Water-bottle shaped heart - Answer-Pericardial effusion, look for pulsus
paradoxus
"Stuck-on" appearance - Answer-Seborrheic keratosis
Red plaques with silvery-white scales and sharp margins - Answer-
Psoriasis
The most common type of skin cancer; lesion is pearly-colored papule
with translucent surface and telangiectasias - Answer-Basal cell
carcinoma
Honey-crusted lesions - Answer-Impetigo
A febrile patient with h/o diabetes presents with red, swollen, painful
lower extremity - Answer-Cellulitis
Positive Nikolsky's sign - Answer-Pemphigus vulgaris
Negative Nikolsky's sign - Answer-Bullous pemphigoid
