USMLE STEP 2 CK SCRIPT 2026 QUESTIONS
AND SOLUTIONS COMPREHENSIVE STUDY
SHEET FULL PRACTICE SET 400
◉ Hypertension screening.
Answer: Age >18 at every visit
Patients >60 years: >150/90 mmHg
Patients <60 years: >140/90 mmHg
Patients >18 years + CKD or diabetes: >140/90 mmHg
◉ Hypertensive Emergency.
Answer: >180/120 mmHg + end-organ damage
- Malignant HTN: severe HTN + retinal hemorrhages, papilledema or
exudates
- Hypertensive encephalopathy: severe HTN + cerebral edema or
non-localizing neurologic signs and symptoms
◉ Osteoporosis Screening.
Answer: Women >65
Start at 60 if decreased body weight or increased risk for fractures
,◉ PPSV23 Alone for age 19-64.
Answer: Chronic heart, lung or liver disease, diabetes, smoker,
alcoholics
◉ Sequential PCV13 + PPSV23 for age 19-64.
Answer: CSF leaks, choclear implants, sickle cell disease, asplenia,
CKD, Inmunocompromised
◉ Sequential PCV13 + PPSV23 for age >65.
Answer: 1 dose of PCV13 followed by PPSV23 at a later time
◉ Marfan Syndrome.
Answer: AD, Upward lens dislocation, normal intellect
◉ Homocystinuria.
Answer: AR, downward lens dislocation, intellectual disability
◉ Criteria for Parathyroidectomy.
Answer: Symptomatic hypercalcemia
Ca >11.5 mg/dL
Renal Insufficiency
,Age <50
Nephrolithiasis
Osteoporosis
Pregnant
◉ Drugs that cause SIADH.
Answer: Carbamazepine, Cyclophosphamide, SSRIs, antipsychotics,
NSAIDs
◉ Herpagina.
Answer: 3-10 yrs
Seasonal (summer/fall)
Ulcers and vesicles in posterior oropharynx
Tx: supportive
◉ Herpetic gingivostomatitis.
Answer: 6mo-5yrs
No seasonality
Clusters of small ulcers on anterior oropharynx
Tx: oral acyclovir
◉ Initial HIV screening.
, Answer: Age 15-65
Treatment of TB
another STD present
Pregnant
Occupational exposure to blood/fluids
◉ Annual Screening for HIV.
Answer: IV drug user + sex partner
Men who have sex with men
Sex for money
Partner of a HIV positive person
>1 partner since last HIV test
Homeless
Correctional facility incarceration
◉ S4 heart sound.
Answer: Atrial gallop sound (before S1)
Heard immediately after atrial contraction phase as blood is forced
into a stiff ventricle
Normal: healthy older adults
AND SOLUTIONS COMPREHENSIVE STUDY
SHEET FULL PRACTICE SET 400
◉ Hypertension screening.
Answer: Age >18 at every visit
Patients >60 years: >150/90 mmHg
Patients <60 years: >140/90 mmHg
Patients >18 years + CKD or diabetes: >140/90 mmHg
◉ Hypertensive Emergency.
Answer: >180/120 mmHg + end-organ damage
- Malignant HTN: severe HTN + retinal hemorrhages, papilledema or
exudates
- Hypertensive encephalopathy: severe HTN + cerebral edema or
non-localizing neurologic signs and symptoms
◉ Osteoporosis Screening.
Answer: Women >65
Start at 60 if decreased body weight or increased risk for fractures
,◉ PPSV23 Alone for age 19-64.
Answer: Chronic heart, lung or liver disease, diabetes, smoker,
alcoholics
◉ Sequential PCV13 + PPSV23 for age 19-64.
Answer: CSF leaks, choclear implants, sickle cell disease, asplenia,
CKD, Inmunocompromised
◉ Sequential PCV13 + PPSV23 for age >65.
Answer: 1 dose of PCV13 followed by PPSV23 at a later time
◉ Marfan Syndrome.
Answer: AD, Upward lens dislocation, normal intellect
◉ Homocystinuria.
Answer: AR, downward lens dislocation, intellectual disability
◉ Criteria for Parathyroidectomy.
Answer: Symptomatic hypercalcemia
Ca >11.5 mg/dL
Renal Insufficiency
,Age <50
Nephrolithiasis
Osteoporosis
Pregnant
◉ Drugs that cause SIADH.
Answer: Carbamazepine, Cyclophosphamide, SSRIs, antipsychotics,
NSAIDs
◉ Herpagina.
Answer: 3-10 yrs
Seasonal (summer/fall)
Ulcers and vesicles in posterior oropharynx
Tx: supportive
◉ Herpetic gingivostomatitis.
Answer: 6mo-5yrs
No seasonality
Clusters of small ulcers on anterior oropharynx
Tx: oral acyclovir
◉ Initial HIV screening.
, Answer: Age 15-65
Treatment of TB
another STD present
Pregnant
Occupational exposure to blood/fluids
◉ Annual Screening for HIV.
Answer: IV drug user + sex partner
Men who have sex with men
Sex for money
Partner of a HIV positive person
>1 partner since last HIV test
Homeless
Correctional facility incarceration
◉ S4 heart sound.
Answer: Atrial gallop sound (before S1)
Heard immediately after atrial contraction phase as blood is forced
into a stiff ventricle
Normal: healthy older adults
