USMLE STEP 2 CK PRACTICE ASSESSMENT
2026 FULL QUESTIONS AND ANSWERS
GRADED A PLUS COMPLETE REVISION GUIDE
400 ITEMS
◉ Pulmonary angiogram (gold standard), but usually used in CT
pulmonary angiography or CT with contrast.
Answer: most accurate test in PE
◉ NO LIP
Nitrates
Oxygen
Loops
Ionotropic drugs (dobutamine)
Positioning (blood pools in the legs)
BNP > 400.
Answer: tx acute CHF
◉ V/Q scan.
Answer: if the patient cannot have CT angio then what imaging do
you use to dx the PE
,◉ CT chest/abdomen/pelvis and PET to look for mets.
Answer: next best step after finding a brain tumor on MRI
◉ pleural:serum protein > 0.5
pleural:serum LDH > 0.6
pleural LDH > 2/3 serum LDH.
Answer: Light's criteria for pleural effusion
◉ LABA's.
Answer: what type of asthma treatment should never be used alone
◉ 1. clinical scenario - unable to count to 10, use of accessory
muscles, etc
2. O2 < 50
3. CO2 > 50
* rule of 50's*.
Answer: when should you intubate
◉ histoplasmosis.
Answer: ohio missipi
,◉ cocciodes.
Answer: southwest US
◉ Wind - atelectasis
Water - UTI
Wound - wound infection
Walking - DVT
Wonder drugs -stuff we give them.
Answer: W's of post-op fever
◉ broncheoalveolar carcinoma.
Answer: repeat lung infections in the same area in patient older than
40 years old
◉ CHADS2 > 2
CHF
HTN (140/70)
Age > 75
DM
Stroke/tia previous (2 pts).
Answer: requirement for anticoagulation in afib
, ◉ amiodorone.
Answer: tx for v tach with a pulse
◉ BB and CCB.
Answer: rate control a fib
◉ < 48 hours - cardioversion
> 48 hours - get TEE to look for intracardiac clot and then
cardiovert/ otherwise rate control + anticoag.
Answer: tx of a fib
◉ 1. abdominal x-ray to look for pneumoperitoneum
2. if so, then immediate surgery, if no then move to contrast enema -
a. if shows microcolon- meconium illeus- Gastriffin enema
b. if shows dilated macrocolon with taper- Hirshprung - recal biopsy.
Answer: work up of bilous emesis
◉ (progressive hip pain - can have normal physcial exam and x-ray
findings early on) - chronic corticosteriods - high RF - get MRI of the
hip.
Answer: next best step for avascular necrosis of the hip
2026 FULL QUESTIONS AND ANSWERS
GRADED A PLUS COMPLETE REVISION GUIDE
400 ITEMS
◉ Pulmonary angiogram (gold standard), but usually used in CT
pulmonary angiography or CT with contrast.
Answer: most accurate test in PE
◉ NO LIP
Nitrates
Oxygen
Loops
Ionotropic drugs (dobutamine)
Positioning (blood pools in the legs)
BNP > 400.
Answer: tx acute CHF
◉ V/Q scan.
Answer: if the patient cannot have CT angio then what imaging do
you use to dx the PE
,◉ CT chest/abdomen/pelvis and PET to look for mets.
Answer: next best step after finding a brain tumor on MRI
◉ pleural:serum protein > 0.5
pleural:serum LDH > 0.6
pleural LDH > 2/3 serum LDH.
Answer: Light's criteria for pleural effusion
◉ LABA's.
Answer: what type of asthma treatment should never be used alone
◉ 1. clinical scenario - unable to count to 10, use of accessory
muscles, etc
2. O2 < 50
3. CO2 > 50
* rule of 50's*.
Answer: when should you intubate
◉ histoplasmosis.
Answer: ohio missipi
,◉ cocciodes.
Answer: southwest US
◉ Wind - atelectasis
Water - UTI
Wound - wound infection
Walking - DVT
Wonder drugs -stuff we give them.
Answer: W's of post-op fever
◉ broncheoalveolar carcinoma.
Answer: repeat lung infections in the same area in patient older than
40 years old
◉ CHADS2 > 2
CHF
HTN (140/70)
Age > 75
DM
Stroke/tia previous (2 pts).
Answer: requirement for anticoagulation in afib
, ◉ amiodorone.
Answer: tx for v tach with a pulse
◉ BB and CCB.
Answer: rate control a fib
◉ < 48 hours - cardioversion
> 48 hours - get TEE to look for intracardiac clot and then
cardiovert/ otherwise rate control + anticoag.
Answer: tx of a fib
◉ 1. abdominal x-ray to look for pneumoperitoneum
2. if so, then immediate surgery, if no then move to contrast enema -
a. if shows microcolon- meconium illeus- Gastriffin enema
b. if shows dilated macrocolon with taper- Hirshprung - recal biopsy.
Answer: work up of bilous emesis
◉ (progressive hip pain - can have normal physcial exam and x-ray
findings early on) - chronic corticosteriods - high RF - get MRI of the
hip.
Answer: next best step for avascular necrosis of the hip
