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Exam (elaborations)

STEP 2 CK FIRST AID RAPID REVIEW

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STEP 2 CK FIRST AID RAPID REVIEW

Institution
USMLE STEP 2 CK
Course
USMLE STEP 2 CK

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STEP 2 CK FIRST AID RAPID REVIEW
Classic ECG finding in atrial flutter. - Answers-"Sawtooth" P waves.

Definition of unstable angina. - Answers-Angina is new, is worsening, or occurs at rest.

Antihypertensive for a diabetic patient with proteinuria. - Answers-ACEI.

Beck's triad for cardiac tamponade. - Answers-Hypotension, distant heart sounds, and
JVD.

Drugs that slow AV node transmission. - Answers-β-blockers, digoxin, calcium channel
blockers.

Hypercholesterolemia treatment that leads to flushing and pruritus. - Answers-Niacin.

Treatment for atrial fibrillation and atrial flutter. - Answers-If unstable, cardiovert. If stable
or chronic, rate control with calcium channel blockers or β-blockers.

Treatment for ventricular fibrillation. - Answers-Immediate cardioversion.

Autoimmune complication occurring 2-4 weeks post-MI. - Answers-Dressler's syndrome:
fever, pericarditis, ↑ ESR.

IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment? -
Answers-Treat existing heart failure and replace the tricuspid valve.

Diagnostic test for hypertrophic cardiomyopathy. - Answers-Echocardiogram (showing
thickened left ventricular wall and outflow obstruction).

A fall in systolic BP of > 10 mmHg with inspiration. - Answers-Pulsus paradoxus (seen in
cardiac tamponade).

Classic ECG findings in pericarditis. - Answers-Low-voltage, diffuse ST-segment
elevation.

Definition of hypertension. - Answers-BP > 140/90 on three separate occasions two
weeks apart.

Eight surgically correctable causes of hypertension. - Answers-Renal artery stenosis,
coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome,
unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism.

Evaluation of a pulsatile abdominal mass and bruit. - Answers-Abdominal ultrasound
and CT.

,Indications for surgical repair of abdominal aortic aneurysm. - Answers-> 5.5 cm, rapidly
enlarging, symptomatic, or ruptured.

Treatment for acute coronary syndrome. - Answers-Morphine, O2, sublingual
nitroglycerin, ASA, IV β-blockers, heparin.

Murmur—hypertrophic obstructive cardiomyopathy (HOCM). - Answers-Systolic ejection
murmur heard along the lateral sternal border that ↑ with Valsalva maneuver and
standing.

Murmur—aortic insufficiency. - Answers-Diastolic, decrescendo, high-pitched, blowing
murmur that is best heard sitting up; ↑ with ↓ preload (handgrip maneuver).

Murmur—aortic stenosis. - Answers-Systolic crescendo/decrescendo murmur that
radiates to the neck; ↑ with ↑ preload (Valsalva maneuver).

Murmur—mitral regurgitation. - Answers-Holosystolic murmur that radiates to the axillae
or carotids.

Murmur—mitral stenosis. - Answers-Diastolic, mid- to late, low-pitched murmur.

What is metabolic syndrome? - Answers-Abdominal obesity, high triglycerides, low HDL,
hypertension, insulin resistance, prothrombotic or proinflammatory states.

Target LDL in a patient with diabetes. - Answers-< 70.

Signs of active ischemia during stress testing. - Answers-Angina, ST-segment changes
on ECG, or ↓ BP.

ECG findings suggesting MI. - Answers-ST-segment elevation (depression means
ischemia), flattened T waves, and Q waves.

Coronary territories in MI. - Answers-Anterior wall (LAD/diagonal), inferior (PDA),
posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal).

A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are
normal. - Answers-Prinzmetal's angina.

Common symptoms associated with silent Mls. - Answers-CHF, shock, and altered
mental status.

The diagnostic test for pulmonary embolism. - Answers-V/Q scan.

An agent that reverses the effects of heparin. - Answers-Protamine.

The coagulation parameter affected by warfarin. - Answers-PT.

, A young patient with a family history of sudden death collapses and dies while
exercising. - Answers-Hypertrophic cardiomyopathy.

Endocarditis prophylaxis regimens. - Answers-Oral surgery—amoxicillin; GI or GU
procedures—ampicillin and gentamicin before and amoxicillin after.

The 6 P's of ischemia due to peripheral vascular disease. - Answers-Pain, pallor,
pulselessness, paralysis, paresthesia, poikilothermia.

Virchow's triad. - Answers-Stasis, hypercoagulability, endothelial damage.

The most common cause of hypertension in young women. The most common cause of
hypertension in young men. - Answers-OCPs. Excessive EtOH.

"Stuck-on" appearance. - Answers-Seborrheic keratosis.

Red plaques with silvery-white scales and sharp margins. - Answers-Psoriasis.

The most common type of skin cancer; the lesion is a pearly-colored papule with a
translucent surface and telangiectasias. - Answers-Basal cell carcinoma.

Honey-crusted lesions. - Answers-Impetigo.

A febrile patient with a history of diabetes presents with a red, swollen, painful lower
extremity. - Answers-Cellulitis.

Pos Nikolsky's sign. - Answers-Pemphigus vulgaris.

Neg Nikolsky's sign. - Answers-Bullous pemphigoid.

A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck.
- Answers-Acanthosis nigricans. Check fasting blood glucose to rule out diabetes.

Dermatomal distribution. - Answers-Varicella zoster.

Flat-topped papules. - Answers-Lichen planus.

Iris-like target lesions. - Answers-Erythema multiforme.

A lesion characteristically occurring in a linear pattern in areas where skin comes into
contact with clothing or jewelry. - Answers-Contact dermatitis.

Presents with a herald patch, Christmas-tree pattern. - Answers-Pityriasis rosea.

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Institution
USMLE STEP 2 CK
Course
USMLE STEP 2 CK

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