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AMBOSS STEP 2 SELF ASSESSMENT; 155 EXAM QUESTIONS WITH 100% VERIFIED ANSWERS
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AMBOSS STEP 2 SELF ASSESSMENT; 155 EXAM QUESTIONS WITH 100% VERIFIED ANSWERS...
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AMBOSS STEP 2 SELF ASSESSMENT; 155EXAM QUESTIONS WITH 100% VERIFIED
ANSWERS
Crescent shaped, concave hemorrhage that crosses the suture lines but
not the falx - ANSWER Subdural hematoma
6 yo M with difficulties at school and intellectual disability, small head,
wide spaced eyes, short palpebral fissures, thin and flat upper lip,
sunken nasal bridge and a small jaw, 3/6 pan systolic murmur heard
best along the left lower sternal border. Cause? - ANSWER Prenatal
alcohol exposure
This is FAS
Most common cause of intellectual disability in the US
6 yo F shortest in her class, HTN, low set hairline, high arched palate,
widely spaced nipples, moderately edematous hands. Risk of developing
which complication? - ANSWER Aortic insufficiency
This is Turner's syndrome
Associated with bicuspid aortic valve and coarctation of the aorta
1 yo M with fever, fatigue, productive cough, recurrent otitis media, hypo
plastic tonsils, pneumonia, absent B cells and normal T cells. NBS? -
ANSWER IVIG
This is Bruton agammaglobulinemia (X-linked agammaglobulinemia)
4 yo M with fever, diffuse joint pain, and a rash, emigrated from China,
tachycardia, polymorphous truncal rash, pink eyes, tongue is red and
shiny, lips are cracked. NBS? - ANSWER Echo
This is Kawasaki disease
Get echo at time of dx to evaluate for coronary artery aneurysms
After dx, give IVIG and high dose oral ASA
19 yo M with progressive difficulty climbing stairs over past 2 years,
problems running and standing from a chair, enlarged calf muscles
bilaterally, waddling gait, and CK of 17k. Most appropriate to confirm dx?
- ANSWER Genetic analysis
This is Becker muscular dystrophy, X-linked recessive
,6 mo M can sit upright without support and roll over from supine to
prone, cannot pull himself to stand, can grasp rattle but cannot transfer it
from one hand to the other. Which developmental milestone is delayed?
- ANSWER Fine motor
Should be able to transfer objects from hand to hand
Gross motor includes ability to sit without support and roll over from the
supine to prone position
4 mo M with noisy breathing for 2 mo that improves when prone and
worse when agitated, feeding, or lying on back. NBS? - ANSWER
Observation
This is Laryngomalacia, which is benign and self limited
29 yo F G1P0 at 24 weeks with tiredness and weight gain WNL. Which
set of labs is most likely to be present? - ANSWER Hgb 11.9
Arterial pH 7.43
PaCO2 32
Bicarb 21
Cr 0.4
Progesterone causes a chronic, compensated respiratory alkalosis
Hgb decreases, GFR increases
Cr, BUN, and uric acid are decreased or borderline low
18 yo F with severe acne on face, back, and arms. OCPs are started,
these reduce the risk of which condition? - ANSWER Endometrial CA by
opposing the effects of estrogen
26 yo F 10 weeks gestation, US with embryo 6mm in length with absent
cardiac activity. NBS? - ANSWER Misoprostol therapy
This is a missed abortion
31 yo F trying to conceive with husband for 18 mo. NBS? - ANSWER
Semen analysis
Start with the male for infertility workup
55 yo M with 2 mo hx of worsening pain and burning in his feet; non
healing painless ulcer on bottom of right second toe; T2DM, glaucoma,
LBBB, chronic back pain; loss of proprioception and sensation to touch,
pinprick, and vibration of the bilateral hands and feet; bilateral ankle
reflexes are absent. NBS to treat pain? - ANSWER Pregabalin
,First-line tx for painful diabetic neuropathy
Amytriptyline is alternative, but glaucoma and LBBB are
contraindications
43 yo F with progressive chest pain, SOB, dizziness, palpitations, b/l
arm numbness, and a feeling that she is choking after receiving bad
news. Sx resolve in 10 mins. NBS? - ANSWER Administer alprazolam
This is an acute panic attack
CBT and SSRIs for longterm management
25 yo M with pain after lifting heavy box at work. Spine is contender
without muscle spasms, straight leg test is negative. Wants letter stating
inability to work. Best response? - ANSWER I understand you are
uncomfortable, but the findings do not match the severity of your sx.
Let's talk about the recent changes at your job
This is malingering - approach in nonthreatening, calm, distant yet
empathetic manner
28 yo F with 1 wk hx of feeling unusually energetic, paces around room,
has not slept. For past 8 mo, believed she is a famous singer. 6 mo ago
started to hear voices telling her to quit her job. Speech is pressured,
stops talking in middle of sentences. Dx? - ANSWER Schizoaffective
disorder
Mood sx in the presence of psychosis
Schizotypal PD would have magical thinking and social anxiety
19 yo M with unusual behavior that started 3 hrs ago at a party, fever,
tachycardia, HTN, diaphoretic, dilated pupils bilaterally, diffuse
hyperreflexia, capillary refill time 3 sec, starts screaming and tries to bite
the physician. Explanation? - ANSWER Synthetic cathinone intoxication
(bath salts)
Sympathetic stimulation and AMS
Cannot be detected with routine urine toxicology
NMS is typically after antipsychotic drug use
3 yo M with swelling and tenderness of left upper arm, refusing to use
arm, clings to mother, swelling and bruising on medial left upper arm and
tenderness along 8th rib, non displaced spiral fracture with callus
formation. NBS? - ANSWER Contact CPS
, 7 yo F with swelling of left periorbital region, painful warm and soft lump
that involves the hair follicles, drains purulent fluid. Dx? - ANSWER
Hordeolum
A chalazion is slowly progressing, firm, rubbery, and nonpurulent
44 yo F with 2 yr hx of progressive dysphagia, food getting stuck in
throat, pillow of fingers, thickening of skin on fingers, small dilated blood
vessels. Most likely cause? - ANSWER Esophageal smooth muscle
atrophy and fibrosis
This is CREST syndrome - esophageal dysmotility
9 yo M with excessively dry skin, worse in winter and better in summer,
spares the skin creases of neck, antecubital fossa and popliteal fossa.
Dx? - ANSWER Ichthyosis vulgaris
Often associated with keratosis pillars - papular elevations of hair
follicles, and hyperlinearity of the palms and soles
18 yo F with 2 day hx of swelling and itchiness of mouth and lips after an
orthodontic procedure 4 days ago. Diffuse erythema and edema of the
buccal mucosa with multiple serous vesicles and shallow ulcers. Most
likely cause? - ANSWER Allergic contact dermatitis
Nickel allergy here
71 yo M with occasional fatigue, HTN, T2DM. Low grade fever,
contender cervical and axillary LAD, splenomegaly. Further eval most
likely to show? - ANSWER Teardrop cells
This is CLL, B-CLL type 9CD19, 20, 23)
49 yo M with tender red nodules on chest x3 days, diarrhea and poor
appetite x1 mo, dry cough and joint pain. Linear, erythematous lesion on
right anterior chest wall through which a cord like structure can be
palpated. NBS? - ANSWER CT of abdomen
This is recurrent migratory thrombophlebitis, which is usually secondary
to pancreatic cancer (Trousseau syndrome)
70 yo M with difficulty swelling x6 mo, occasionally coughs up
undigested food. Foul smelling breath and a fluctuant mass on right side
of neck. Most likely involved pathogenesis? - ANSWER Abnormal
esophageal motor function
This is Zenker diverticulum - inadequate relaxation of the upper
esophageal sphincter causing an out pouching of the pharyngeal wall
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