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USMLE Step 2 CK Questions And Answers All Are Correct Tests

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USMLE Step 2 CK Questions And Answers All Are Correct Tests pregnant with active HBV Correct Answer: tx newborn with HBIG and HBV vaccine Beck's triad for tamponade Correct Answer: hypotension... , JVD, muffled heart sounds (also pulsus paradoxus). Electrical alternans subarachnoid hemorrhage Correct Answer: increased ADH and BNP --> hyponatremia. Tx - water restriction coccidioidomycosis Correct Answer: SW US, central/south America. Pulm infection - dry cough, weight loss, pleuritic chest pain, erythema multiforme/nodosum, arthralgias histoplasmosis Correct Answer: SE US, mid Atlantic, central US, caves. Acute PNA, but usually asymptomatic. HIV disseminated infection- hilar LAD, pneumonitis, pancytopenia, hepatosplenomegaly, palatal ulcers. tx- IV amphotericin B followed by lifelong itraconazole. Blastomycosis Correct Answer: central US (most in Wisconsin). Often asymptomatic or flu-like Sx. Systemic disease- lytic bone lesions, pulmonary infection, skin lesions. Dx- broad-based budding yeast. Tx- itraconazole, amphotericin B aspergillosis Correct Answer: invasive in IMCD. CXR - cavitary lesions. CT - pulm nodules, halo sign, air crescent sporotrichosis Correct Answer: subcutaneous infection. Gardeners. Travel up lymphatics for nodules on forearms cryptococcus Correct Answer: pulm infection often asymptomatic. Usually meningoencephalitis in HIV with CD4<200 hemochromatosis infections Correct Answer: Listeria monocytogenes, Yersinia enterocolitica, septicemia - Vibrio vulnificus Narcolepsy treatment Correct Answer: methyldphenidate, modafinil, antidepressants (for cataplexy) galactorrhea Correct Answer: test B-HCG, prolactin, TSH septic abortion Correct Answer: cervical/blood cultures, antibiotics, gentle suction currettage Lesch-Nyhan Correct Answer: x-linked recessive, HPRT deficiency, increased uric acid. Sx - self mutilation, dystonia, spacticity, gout. Presents at 6 months. minimal change disease Correct Answer: tx - prednisone, cyclophosphamide for resistant cases/frequent relapse Sturge-Weber Correct Answer: seizures, retardation, trigeminal port-wine stain, hemi neuro findings, tramline intracranial calcifications tuberous sclerosis Correct Answer: seizures, retardation, intracranial calcifications (tubers), ashleaf spots, adenoma sebaceum (red papules on face) osteogenesis imperfecta Correct Answer: autosomal dominant. Type 1 collagen problem. Type 2 most severe with perinatal fractures and often intrauterine death. Blue sclera, fractures, hypotonia, hearing loss, joint hypermobility, dentinogenesis imperfecta polymyalgia rheumatica Correct Answer: neck/shoulder/hip pain/stiffness. >50 years old, high ESR. Tx- low dose prednisone, high dose for temporal arteritis massive blood transfusion Correct Answer: citrate anticoagulant --> chelates Ca and Mg --> low Ca --> paresthesias, hyperactive reflexes nephrotic syndrome Correct Answer: dyslipidemia, accelerated atherosclerosis, hypercoagulable, risk for MI/stroke, higher infxn susceptibility. Can have renal vein thrombosis, usually with membranous GN aortic regurgitation Correct Answer: early diastolic (mild) to holodiastolic (severe) murmur. Bounding pulses. Tx- decrease afterload with DHP Ca-channel blockers, ACEi, NOT beta blockers. mycoplasma PNA Correct Answer: erythema multiforme. No cell wall so not on gram stain candidal vulvovaginitis Correct Answer: pseudohyphae. In IMCD and Abx treated people. Tx- oral fluconazole, topical nystatin nonseminomatous germ cell tumor Correct Answer: large anterior mediastinal mass, young males. High HCG and AFP. seminoma Correct Answer: high HCG but normal AFP thymoma Correct Answer: associated with myasthenia gravis, pemphigus hepatocellular carcinoma Correct Answer: high AFP but normal HCG choriocarcinoma Correct Answer: gestational trophoblastic disease usually in molar pregnancy. Very high HCG C. dif diagnosis Correct Answer: cytotoxin assay of stool Erb-Duchenne palsy Correct Answer: C5, C6. waiter's tip, absent Moro but intact grasp Klumpke's paralysis Correct Answer: C7, C8, T1. hand paralysis, Horner's (ptosis, miosis) dermatitis herpetiformis Correct Answer: papulovesicular, pruritic. Associated with Celiac. Dx - IgA anti-endomysial Ab, anti-gliadin phenelzine Correct Answer: MAOi antidepressant. Avoid tyramine (aged meat/cheese) --> HTN crisis CMV esophagitis Correct Answer: in HIV. Dysphagia, odynophagia, shallow ulcers, intranuclear/cytoplasmic inclusions. Tx- ganciclovir IV HSV esophagitis Correct Answer: in HIV. Small ulcers with volcano-like appearnace. Eosinophilic intranuclear inclusions. Tx- acyclovir candidal esophagitis Correct Answer: most common HIV esophagitis. Tx - oral fluconazole splenic rupture Correct Answer: ex-lap if unstable. CT if stable pseudocyesis Correct Answer: pregnancy conversion disorder prolactin Correct Answer: stimulated by serotonin and TRH, inhibited by dopamine. Hypothyroid --> amenorrhea/galactorrhea adenomyosis Correct Answer: endometrial glands in myometrium. Usually > 40yo, dysmenorrhea, menorrhagia, enlarged symmetric uterus. Must curettage to r/o endometrial carcinoma leiomyoma/fibroids Correct Answer: irregular shaped uterus endometriosis Correct Answer: uterus not enlarged. Dysmenorrhea, dyspareunia, dyschezia. Dx- laparoscopy. Tx- OCPs aminoglycosides Correct Answer: amikacin, gentamicin, tobramicin. ototoxic, nephrotoxic. Gentamicin very ototoxic hydroxychloroquine Correct Answer: DMARD. Treats SLE. SE - retinopathy/corneal damage (need q6month eye exams), GI, hemolysis in G6PD methotrexate SE Correct Answer: DMARD. Inhibits folate metabolism. Macrocytic anemia, GI, hepatotoxic, ILD, alopecia, pancytopenia premature ovarian failure Correct Answer: low estrogen, high FSH > LH, <40yo hyperparathyroidism Correct Answer: hypercalcemia - stones, bones, groans, psyciatric overtones, polydipsia, polyuria. pseudogout. Also sometimes HTN low-grade (without mets) gastric MALT lymphoma Correct Answer: H pylori association. Tx- PPI, clarithromycin, amoxicillin Jarisch-Herxheimer rxn Correct Answer: primary/secondary syphilis treated with penicillin --> spirochetes die --> immune complexes --> looks like syphilis flare-up INH SE Correct Answer: hepatitis, peripheral neuropathy/ataxia (give pyridoxine) fanconi anemia Correct Answer: pancytopenia, congenital anomalies, presents 4-12yo. Autosomal recessive. Skin changes diamond-blackfan Correct Answer: pure red cell aplasia, congenital anomalies. Presents 3 months old. Tx - steroids, possibly transfusion transient erythroblastopenia of childhood Correct Answer: RBC aplasia. Presents 6mo - 5yo psoriatic arthritis Correct Answer: DIP, dactylitis. Tx- NSAID, anti-TNF, methotrexate, NOT steroids RA Correct Answer: MCP, PIP, not DIP. Tx- methotrexate, hydroxychloroquine, TNF inhibitors (infliximab, etanercept) OA Correct Answer: DIP adjustment disorder Correct Answer: within 3 months of event, lasts < 6 months post-event. Tx- cognitive/psychodynamic psychotherapy cushing's Correct Answer: high corticosteroids, central obesity, DM, proximal muscle weakness, psychosis, thin skin, purple striae, osteoporosis, hypokalemic alkalosis, secondary HTN APML Correct Answer: Tx- ATRA CML Correct Answer: leukocytosis, anemia, increased granulocytic forms (PMNs, bands), leuk alk phosh low (high in leukemoid reaction). Philadelphia chromosome, t(9:22), BCR-ABL gene. Tx- tyrosine kinase inhibitors (imatinib). Usually > 50yo McCune-Albright Correct Answer: 3 P's - precocious puberty, pigmentation (café-au-lait), polyostotic fibrous dysplasia. Associated with other endocrine d/o's - hyperthyroid, prolactinoma, growth hormone, cushing's von Recklinghausen/NF1 Correct Answer: autosomal dominant. café-au-lait, axillary/genital freckling, Lisch nodules, neurofibromas, bony lesions, tumors. NF2 Correct Answer: autosomal dominant. brain tumors, bilateral acoustic neuromas, other tumors. Peutz-Jeghers Correct Answer: autosomal dominant. GI polyposis, mucocutaneous pigmentation, precocious puberty Wiskott-Aldrich Correct Answer: x-linked recessive. Eczema, thrombocytopenia, hypogammaglobulinemia. Infections with encapsulated bacteria. Low platelet production, small platelets TCA toxicity Correct Answer: hyperthermia, seizures, hypoTN, anticholinergic Sx, long QRS (indicates severity of overdose), V-arrythmias. Tx- sodium bicarb slipped capital femoral epiphysis Correct Answer: risk factors: obesity, hypothyroid, growth hormone deficiency/supplementation. tx- surgical pinning. Dx- late [Show More]

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