STEP 2 CK USMLE COMPLETE
QUESTIONS AND ANSWERS
First-line meningitis treatment - CORRECT ANSWER
Cefotaxime or Ceftriaxone + Vancomycin
What is the best way to treat pseudomonas? - CORRECT
ANSWER-Zosyn
What are gram-positive diplococci? - CORRECT ANS...
What is the best way to treat pseudomonas? - CORRECT
ANSWER-Zosyn
What are gram-positive diplococci? - CORRECT ANSWER-S.
Pneumoniae
What are gram-negative diplococci? - CORRECT ANSWER-
Neisseria
What are gram-negative coccobacilli? - CORRECT ANSWER-
Haemophilus
Plump gram-negative rod with thick capsule (mucoid) -
CORRECT ANSWER-Klebsiella
What is the gold standard for pneumonia diagnosis? -
CORRECT ANSWER-Sputum culture
What population is S. aureus pneumonia common? -
CORRECT ANSWER-HCAP, CF patients, IV drug users.
,Empyemas and lung abscesses are common.
When does one see pseudomonas PNA vs Klebsiella PNA? -
CORRECT ANSWER-Pseudomonas PNA occurs with CF
classically (and nursing homes)
Klebsiella occurs with alcoholics
Lab test to differentiate atypical PNA bugs - CORRECT
ANSWER-Look for positive cold-agglutinin antibody titers
(positive in mycoplasma PNA, negative in chlamydia PNA)
What should one be wary of when stuck with a thorn/gardening,
how to treat? - CORRECT ANSWER-Sporothrix schenckii, tx
with itraconazole
Aplastic crisis in SCD - CORRECT ANSWER-Parvovirus
What bugs commonly cause sepsis after splenectomy? -
CORRECT ANSWER-Encapsulated bacteria: H. influenzae, S.
pneumoniae, Neisseria meningitis
Bug: PNA after exposure to parrot - CORRECT ANSWER-
Chlamydophila psittaci, gram-positive, treat with azithromycin
or tetracycline
Diarrhea after hiking/drinking from a stream, how to treat? -
CORRECT ANSWER-Giardia, tx with metronidazole
What should one be wary of when one sees seizures + ring-
enhancing brain lesions on CT, how to treat? - CORRECT
ANSWER-T solium or toxoplasmosis, (tx t. solium with
albendazole/praziquantel and steroids)
Food poisoning after eating raw seafood - CORRECT
ANSWER-Vibrio parahaemolyticus
,Diarrhea after travel to Mexico, what bug and how to treat? -
CORRECT ANSWER-E. Coli, tx with ciprofloxacin
What does a burn wound infection with blue/green color mean?
- CORRECT ANSWER-Potential pseudomonas infection
What happens to FTA-ABS and MHA-TP tests after syphilis is
treated? - CORRECT ANSWER-Will often remain positive for
life
Diagnosis and infectious agent: child < 3 yo with 4 days of high
fever + maculopapular rash afterward on chest and abd -
CORRECT ANSWER-Roseola infantum caused by Herpes
virus 6. Key: child < 3 who has maculopapular rash on chest
and abd. Rare after the age of 3.
What is parvovirus B19 known for (2)? - CORRECT ANSWER-
1. Slapped cheek rash with mild constitutional symptoms in kids
2. Aplastic crisis in Sickle Cell Disease
Also causes RA-like illness in joints
When is chickenpox no longer infectious? - CORRECT
ANSWER-When the last lesion crusts over
How does one diagnose chickenpox? - CORRECT ANSWER-
Tzank smear showing vesicle containing multinucleated giant
cells
What disease should be on the differential for any child with
MI? - CORRECT ANSWER-Kawasaki's disease
What is the main cause of acute endocarditis? - CORRECT
ANSWER-S. Aureus
, What should be suspected as causative agent if pt has
subacute endocarditis and CRC? - CORRECT ANSWER-
Streptococcus bovis
What is empirical treatment for prosthetic valve endocarditis? -
CORRECT ANSWER-Vanc + gent + cefepime / carbapenem
What is the medication of choice for endocarditis prophylaxis? -
CORRECT ANSWER-Amoxicillin
When are most meningitis cases found?
What is the most common bug? - CORRECT ANSWER-Kids <
2 yo.
Strept agalactiae (group B strept)
What is the most common sequelae from meningitis? -
CORRECT ANSWER-Hearing loss
Which types of bacterial meningitis require antibiotic
prophylaxis? - CORRECT ANSWER-N. meningitidis and H.
influenzae
What should one do if patient comes in with animal bite (3
steps)? - CORRECT ANSWER-1. Clean wound with soap, do
not cauterize or suture. 2. Give augmentin to prevent cellulitis.
3. Capture animal to see if has rabies. Do not give vaccine or
IG unless rabies suspicion is high.
How should post-strep GN be treated? - CORRECT ANSWER-
Treat supportively
What is the difference between cellulitis and erysipelas? -
CORRECT ANSWER-Erysipelas involves more superficial
tissue.
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