USMLE Step 2 CS Mini-cases Exam
Questions with Correct Verified
Answers Latest Update (2024/2025)
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81 yo M presents with progressive
confusion over the past several
years together with forgetfulness
and clumsiness. He has a history of
hypertension, diabetes mellitus, and two
strokes with residual left hemiparesis. His
mental status has clearly worsened after
each stroke (stepwise decline in cognitive
function). - ANS ✓Vascular ("multi-infarct")
dementia
Alzheimer's disease
Normal pressure hydrocephalus
Chronic subdural hematoma
Intracranial tumor
Depression
B12 defi ciency
Neurosyphilis
Hypothyroidism
USMLE Step 2 CS Minicases
, 2
USMLE
W/U:
CBC
VDRL/RPR
Serum B12
TSH
MRI—brain
CT—head
LP—CSF analysis (rare)
84 yo F brought by her son c/o
forgetfulness (e.g., forgets phone
numbers, loses her way back home) along
with diffi culty performing some of her
daily activities (e.g., bathing, dressing,
managing money, using the phone). The
problem has gradually progressed over
the past few years. - ANS ✓Alzheimer's disease
Vascular dementia
Depression
Hypothyroidism
Chronic subdural hematoma
Normal pressure hydrocephalus
Intracranial neoplasm
B12 defi ciency
Neurosyphilis
W/U:
CBC
VDRL/RPR
USMLE Step 2 CS Minicases
, 3
USMLE
Serum B12
TSH
MRI—brain (preferred)
CT—head
LP—CSF analysis (rare)
72 yo M presents with memory loss, gait
disturbance, and urinary incontinence for
the past six months. - ANS ✓Normal pressure
hydrocephalus
Alzheimer's disease
Vascular dementia
Chronic subdural hematoma
Intracranial neoplasm
Depression
B12 defi ciency
Neurosyphilis
Hypothyroidism
W/U:
CT—head
LP—opening pressure and CSF
analysis
Serum B12
VDRL/RPR
TSH
55 yo M presents with a rapidly
progressive change in mental status,
USMLE Step 2 CS Minicases
, 4
USMLE
inability to concentrate, and memory
impairment for the past two months. His
symptoms are associated with myoclonus
and ataxia. - ANS ✓Creutzfeldt-Jakob disease
Vascular dementia
Lewy body dementia
Wernicke's encephalopathy
Normal pressure hydrocephalus
Chronic subdural hematoma
Intracranial neoplasm
Depression
Delirium
B12 defi ciency
Neurosyphilis
W/U:
CBC, electrolytes, calcium
Serum B12
VDRL/RPR
MRI—brain (preferred)
CT—head
EEG
LP—CSF analysis
Brain biopsy
70 yo insulin-dependent diabetic M
presents with episodes of confusion,
dizziness, palpitation, diaphoresis, and
weakness. - ANS ✓Hypoglycemia
USMLE Step 2 CS Minicases
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