Exam (elaborations)
USMLE STEP 2 CK NEXT STEP IN MANAGEMENT
- Course
- Institution
USMLE STEP 2 CK NEXT STEP IN MANAGEMENT
[Show more]
Content preview
USMLE STEP 2 CK: NEXT STEP IN MANAGEMENTHigh-grade reflux in females that persists into adulthood with no clear secondary cause
- Answers-surgical repair
Multiple 2nd trimester spontaneous abortions - Answers-cervical cerclage
Erythematous knee with effusion and fever - Answers-arthrocentesis [ need to tell apart
gout from septic arthritis]
Spontaneous pneumothorax in a tall young man - Answers-supplemental oxygen
Clue cells seen in vaginal swab in a fertile woman - Answers-oral metronidazole
Mini-mental status exam of <24 - Answers-neuropsychologic testing to rule-out
alzheimer's (other causes of dementia)
Cord compression confirmed with CT-spine - Answers-dexamethasone ( before MRI of
the spine to gold-standard confirm cord compression)
Borderline personality disorder - Answers-dialectical behavioral therapy
Pulmonary edema in acute CHF exacerbation - Answers-100% O2 therapy
Pulmonary edema in acute CHF exacerbation after 100% O2 therapy - Answers-IV
furosemide
Supraventricular tachycardia with HR=160 bpm with p-wave preceding all QRS sinus
rhythm - Answers-Vagal manuevers first -carotid massage, then valsalva , then
pharmacological-ccbs or adenosine
Asymptomatic aortic stenosis - Answers-Hydrocholorothiazide to reduce preload
Hypertension with underlying diabetes type 2 - Answers-ACE-inhibitor or ARB
Syncope with normal vitals and no previous episodes - Answers-Check the electrolytes
and medications - thiazide diuretics can cause hypokalemia and arrythmia
PR interval=o.3 sinus rhythm normal - Answers-Nothing, no management needed;
PR>0.2 is first degree heartblock
A-fib secondary to hypertension for >48 hours - Answers-Diltiazem; rate control +
anticoagulant
, Acute open-angle glaucoma - Answers-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 - Answers-CT scan of the face (coronal section)
Someone with tinnitus, progressive hearing loss, and multiple episodes of vertigo -
Answers-dietary restrictions- particularly of caffeine, salt, and tobacco (Meniere's
disease)
Someone that comes in with headaches and shows papilledema in the opthalmic exam
- Answers-CT scan of the head non-contrast - r/o mass
Treament for scabies - Answers-permethrin
Scaphoid fracture that is negative on X-ray - Answers-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 - Answers-decompression of the GI tract...requires nasogastric tube
A patient presents with hypertension and chest pain on exertion - Answers-IV
nitroglycerin for lowering the blood pressure
Palpitations with underlying lung disease i.e. COPD - Answers-72 hr Holter monitor
Angina symptoms - Answers-Beta-blockers - they increase the threshold of angina
Posterior anterolateral MI and Percutaneous coronary intervention - Answers-
Clopidogrel
Teenage patient grunting and blinking many times a day for at least 1 year - Answers-
haloperidol
Suspected pulmonary embolism - Answers-spiral CT scan
Prinzmetal angina - Answers-calcium channel blockers or nitrates (also for esophageal
spasm)
Lambert Eaton Syndrome - Answers-radiation and chemotherapy as it is the
manifestation of a pre-existing small cell carcinoma of the lung.
Stroke outside the 3 hour period but within 6 hours - Answers-intra-arterial tpa
administration
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller GEEKA. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
77254 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now