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USMLE STEP 2 UWORLD EXAM WITH CORRECTLY ELABORATED QUESTIONS LATEST UPDATE , EXAMS OF NURSING
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USMLE STEP 2 UWORLD EXAM WITH CORRECTLY ELABORATED QUESTIONS LATEST UPDATE , EXAMS OF NURSING
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USMLE STEP 2 UWORLD EXAM WITHCORRECTLY ELABORATED QUESTIONS
LATEST UPDATE 2024-2025, EXAMS OF
NURSING
Myasthenia gravis patient with preeclampsia with severe
features. Medications thats contraindicated?
magnesium sulfate.
- can cause hyporeflexia and loss of DTR
- patients with MG, under stress are prone to myasthenic crisis.
- also would want to avoid labetolol in this patient.
- consider hydralazine as alternative
Seizure prophylaxis for preeclampsia with severe features in
a patient with MG?
valproic acid
Vasomotor symptom treatment in a woman with no
contraindications to therapy and had hysterectomy?
transdermal estrogen patch
- if uterus is present use- estrogen/progestin mini pills.
- progestin is added to prevent endometrial hyperplasia.
- if contradinication is present for treatment: use SSRI
_____________________ is highly present and underreported
and screening should be perfomred in all women of
,childbearing age at any routine medical visit (well woman-
prenatal)
intimate partner violence
irregularly enlarged uterus with spherical mass presenting
through external OS- patient reports significant pain 2 days
after period and describes it as feeling like labor contractions
leiomyoma uteri
- a type of fibroid that is submucosal
-submucosal fibroids are termed intracavitary and can prolapse
through the endometrial cavity into the cervical os.
- causes labor like pain due to cervical dilation and is preceded
by heavy vaginal bleeding.
A female presents with urinary urgency and subsuqently
develops incontinence. UA is positive for LE. Next step?
oral antibiotics
- UA is consistent with UTI
- typically present with dysuria, suprapubic pain, and dysuria,
however can be more subtle and present with acute onsent
incontinence due to bladder spasm from irritation.
- POS LE is needed for diagnosis.
Pregnant patient 14 weeks gestation with a history of type 2
DM, She use to drink 1-2 glasses of wine a night but quit a
year ago due to preparing for pregnancy. PHysical exam is
,benign. Liver enzymes are elevated with ALT 115, and AST
125, ALK phosphatase 145. US of abdomen shows
hyperechoic liver appearing liver, several gallstone buts no
thickening and normal appearing bile duct. Diagnosis?
nonalcoholic fatty liver disease
- common in type 2 DM or metabolic syndrome
- requires diagnosis of exlcusion: such as alcohol use and other
causes of fatty liver disease
- AST/ALT <1
- US show hyperechoic architecture
_______ or _______ typically presents with RUQ pain and
aminotransferase elevation in third trimester of pregnancy.
Thrombocytopenia is commonly present.
preeclampsia with severe features or acute fatty liver of
pregnancy.
- preeclampsia with severe features will present with elevated
blood pressure.
_______ causes elevated bilirubin levels and elevated liver
enzymes. May present with fetal demise. Patient will present
with severe pruritis on palms and soles.
intrahepatic cholestasis of pregnancy.
- treatment: ursodeoxycholic acid
, Treatment of migraines in pregnancy refractory to
acetaminophine?
aceteaminophine with codeine
(can also use promethazine, caffeine/bulbalital)
- NSAID's if migraine occuring in second trimester (due to risk of
miscarriage in 1st trimester and PDA closure in third.
- opioids if refractory to the above.
ergotamine and sumatriptan are avoided in acute migraines
in pregnancy due to the risk of ______ and _______.
preterm labor and IUGR
- vasoconstrictive can lead to uteroplacental insufficiency and also
can stimulate uterine contractions.
Is it ethical to perform procedures on deceased patients for
training purposes after being instructed by your attending?
yes- but must have consent from the family prior to death.
________ and destruction of the _________ are the primary
pathologies associated with COPD.
air trapping and alveolar capillary membrane
- air trapping leads to increased TLC and RV, and decreases the
vital capacity
- destruction of alveolar capillary membrane results in loss of lung
compliance with increased distensibility (decreased elasticity)
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