USMLE Step 2 CK Next Step in Management with complete solution

high-grade reflux in females that persists into adulthood with no clear secondary cause - surgical repair multiple 2nd trimester spontaneous abortions - cervical cerclage erythematous knee with effusion and fever - arthrocentesis [ need to tell apart gout from septic arthritis] spontaneous pneumothorax in a tall young man - supplemental oxygen clue cells seen in vaginal swab in a fertile woman - oral metronidazole acute open-angle glaucoma - 1)beta-2-antagonist eye drops i.e. timolol, betaxolol 2) carbonic anhydrase inhibitors 3) if medication fails, then a trabeculoplasty or trabeculectomy can improve aqueous drainage chronic sinusitis - CT scan of the face (coronal section) someone with tinnitus, progressive hearing loss, and multiple episodes of vertigo - dietary restrictions- particularly of caffeine, salt, and tobacco (Meniere's disease) someone that comes in with headaches and shows papilledema in the opthalmic exam - CT scan of the head non-contrast - r/o mass treament for scabies - permethrinScaphoid fracture that is negative on X-ray - spica cast and re-evaluate in 2~3 weeks 3-hour old infant with poor feeding who vomits green material and has a double-bubble on KUB - decompression of the GI tract...requires nasogastric tube mini-mental status exam of <24 - neuropsychologic testing to rule-out alzheimer's (other causes of dementia) cord compression confirmed with CT-spine - dexamethasone ( before MRI of the spine to goldstandard confirm cord compression) borderline personality disorder - dialectical behavioral therapy Pulmonary edema in acute CHF exacerbation - 100% O2 therapy Pulmonary edema in acute CHF exacerbation after 100% O2 therapy - IV furosemide supraventricular tachycardia with HR=160 bpm with p-wave preceding all QRS sinus rhythm - Vagal manuevers first -carotid massage, then valsalva , then pharmacological-CCBs or adenosine Asymptomatic aortic stenosis - Hydrocholorothiazide to reduce preload Hypertension with underlying diabetes type 2 - ACE-inhibitor or ARB Syncope with normal vitals and no previous episodes - Check the electrolytes and medications - thiazide diuretics can cause hypokalemia and arrythmia