,
,USMLE Step 2 CK – High-Yield Review Notes for
Rapid Revision (United States Medical Licensing
Examination, 2024) – Clinical Key Facts &
Mnemonics. Over 2000 Questions and Correct
Answers.
Slipped Capital Femoral Epiphysis
requires immediate surgical screw fixation to reduce risk of AVN
Obese Child
with dull hip PAIN or referred knee pain and a painful limp
with restricted ROM and inability to bear weight
on exam has limited rotation and abduction of the hip
Diagnosis & Tx?
Legg-Calve-Perthes Disease or Idiopathic Osteonecrosis (avascular necrosis) of the femoral epiphysis.
-Flattened and fragmented femoral head on radiograph
Tx:
Mild: Observation
Moderate: bracing, hip abduction with a petrie cast
Extensive: osteotomy
chronic, progressive leg pain and limp in a 3-12 yo Boy
Limited abduction and internal rotation. Atrophy of proximal thigh muscles.
Diagnosis & Tx?
, pulsus paradoxus
-Associated with cardiac Tamponade
-Becktriad can diagnose acute cardiac tamponade:
1. JVD (Kussmaul sign (increased JVD on inspiration))
2. Hypotension
3. Distant heart sounds
fluid accumulation in pericardial cavity increases intrapericardial pressure restricting venous return to
the heart lowering R & L ventricular filling. Net result = Decreased Preload, Stroke Volume , Cardiac
output.
fall in systemic arterial pressure by more than 10mmHg during inspiration. What is it? and what cardiac
problem is it associated with?
aortic stenosis
Most common causes:
1. senile calcific aortic stenosis (Elderly)
2. bicuspid aortic valve (<70 yo)
3. rheumatic heart disease
high resistance generated by stenosed aortic valve causes concentric hypertrophy and stiffening of the
left ventricle (S4) leading to CHF.
Pulsus Parvus (decreased pulse amplitude) and Pulsus Tardus (delayed pulse upstroke)
(weak,delayed carotid upstroke) and a single or paradoxically split S2 sound;
systolic murmur radiating to the carotids.
associated with what cardiac defect?
aortic regurgitation
-Congenital Bicuspid Aortic Valve, Rheumatic Heart Disease, Endocarditits, Aortic Root Dilation (Marfan,
Syphilis)
-tx: Vasodilator therapy (dihydropyridines or ACEIs) for isolated aortic regurgitation until symptoms
become severe enough to warrant valve replacement.
Bounding or "water hammer" pulses, with widened pulse pressure and head bob with heartbeat are
associated with what cardiac defect? Common etiologies? Treatment?
,USMLE Step 2 CK – High-Yield Review Notes for
Rapid Revision (United States Medical Licensing
Examination, 2024) – Clinical Key Facts &
Mnemonics. Over 2000 Questions and Correct
Answers.
Slipped Capital Femoral Epiphysis
requires immediate surgical screw fixation to reduce risk of AVN
Obese Child
with dull hip PAIN or referred knee pain and a painful limp
with restricted ROM and inability to bear weight
on exam has limited rotation and abduction of the hip
Diagnosis & Tx?
Legg-Calve-Perthes Disease or Idiopathic Osteonecrosis (avascular necrosis) of the femoral epiphysis.
-Flattened and fragmented femoral head on radiograph
Tx:
Mild: Observation
Moderate: bracing, hip abduction with a petrie cast
Extensive: osteotomy
chronic, progressive leg pain and limp in a 3-12 yo Boy
Limited abduction and internal rotation. Atrophy of proximal thigh muscles.
Diagnosis & Tx?
, pulsus paradoxus
-Associated with cardiac Tamponade
-Becktriad can diagnose acute cardiac tamponade:
1. JVD (Kussmaul sign (increased JVD on inspiration))
2. Hypotension
3. Distant heart sounds
fluid accumulation in pericardial cavity increases intrapericardial pressure restricting venous return to
the heart lowering R & L ventricular filling. Net result = Decreased Preload, Stroke Volume , Cardiac
output.
fall in systemic arterial pressure by more than 10mmHg during inspiration. What is it? and what cardiac
problem is it associated with?
aortic stenosis
Most common causes:
1. senile calcific aortic stenosis (Elderly)
2. bicuspid aortic valve (<70 yo)
3. rheumatic heart disease
high resistance generated by stenosed aortic valve causes concentric hypertrophy and stiffening of the
left ventricle (S4) leading to CHF.
Pulsus Parvus (decreased pulse amplitude) and Pulsus Tardus (delayed pulse upstroke)
(weak,delayed carotid upstroke) and a single or paradoxically split S2 sound;
systolic murmur radiating to the carotids.
associated with what cardiac defect?
aortic regurgitation
-Congenital Bicuspid Aortic Valve, Rheumatic Heart Disease, Endocarditits, Aortic Root Dilation (Marfan,
Syphilis)
-tx: Vasodilator therapy (dihydropyridines or ACEIs) for isolated aortic regurgitation until symptoms
become severe enough to warrant valve replacement.
Bounding or "water hammer" pulses, with widened pulse pressure and head bob with heartbeat are
associated with what cardiac defect? Common etiologies? Treatment?
