The Next Best Step Vignettes (USMLE Step 2 CK)
compare to previous chest x-ray ️️when you find a pulmonary nodule on chest x-ray
Pulmonary angiogram (gold standard), but usually used in CT pulmonary angiography or CT with
contrast ️️most accurate test in PE
NO LIP
Nitrates
Oxyge...
LABA's ✔️✔️what type of asthma treatment should never be used alone
1. clinical scenario - unable to count to 10, use of accessory muscles, etc
2. O2 < 50
,3. CO2 > 50
* rule of 50's* ✔️✔️when should you intubate
histoplasmosis ✔️✔️ohio missipi
cocciodes ✔️✔️southwest US
Wind - atelectasis
Water - UTI
Wound - wound infection
Walking - DVT
Wonder drugs -stuff we give them ✔️✔️W's of post-op fever
broncheoalveolar carcinoma ✔️✔️repeat lung infections in the same area in patient older than 40
years old
CHADS2 > 2
CHF
HTN (140/70)
Age > 75
DM
Stroke/tia previous (2 pts) ✔️✔️requirement for anticoagulation in afib
amiodorone ✔️✔️tx for v tach with a pulse
BB and CCB ✔️✔️rate control a fib
< 48 hours - cardioversion
,> 48 hours - get TEE to look for intracardiac clot and then cardiovert/ otherwise rate control + anticoag
✔️✔️tx of a fib
1. abdominal x-ray to look for pneumoperitoneum
2. if so, then immediate surgery, if no then move to contrast enema -
a. if shows microcolon- meconium illeus- Gastriffin enema
b. if shows dilated macrocolon with taper- Hirshprung - recal biopsy ✔️✔️work up of bilous emesis
(progressive hip pain - can have normal physcial exam and x-ray findings early on) - chronic
corticosteriods - high RF - get MRI of the hip ✔️✔️next best step for avascular necrosis of the hip
halothane and succinylcholine - tx dantrolene ✔️✔️which anesthetics are associated with malignant
hyperthermia? tx
cerebellum ✔️✔️in what part of the brain is the intention tremor
UMN ✔️✔️bulbar symptoms are associated with UMN or LMN
atropine, if non-responsive then epi/dopamine or transcutaneous pacing ✔️✔️tx of persistent
bradycardia
amiodorone (always check LFT's, PFT's, and TFT's) ✔️✔️tx of ventricular tachy with a pulse
IV glucagon, K, and insulin ✔️✔️tx of suspected BB overdose
decrease in arterial elasticity ✔️✔️cause of isolated systolic hypertension
1. ACE -/ ARB
2. BB
, 3. spiranolactone ✔️✔️confer a decrease in mortality in CHF patients
no BB (crazy high BP), but yes to lorazepam ✔️✔️which drug should be given in a patient with
cocaine-induced MI
BB/ CCB ✔️✔️rate control afib
adenosine ✔️✔️tx of supraventricular tachy
procanimide (look for the delta wave) ✔️✔️tx of Wolf -parkinson white
pulmonary veins ✔️✔️where does afib originate
symptomatic - 70-99
assymptomatic 60-99 ✔️✔️when is CEA recommended
IV fouresemide ✔️✔️tx of flash pulmonary edema in the context of an MI
for original one - Troponin T, then for second CK-MB ✔️✔️what marker do we use to diagnose a
reinfarction
compression US ✔️✔️high pretest probability DVT
BUN/creat > 20 ✔️✔️how to determine pre-renal failure
restrictive ✔️✔️cardiac calcifications
nausea/vomiting/diahrea, and confusion and weakness, can get colored vision changes
✔️✔️symptoms of digoxin tox
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 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 CertifiedGrades. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £8.29. You're not tied to anything after your purchase.
