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USMLE Step 2 CK > More Step 2 Ck > Flashcards

More Step 2 Ck Flashcards

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USMLE® Step 1 flashcards
1
Q

Mom at 27 weeks gestation is now in labor. She had routine prenatal care during pregnancy.

How do you manage?

A

🔑 27w gestation = pre-term labor (∴ anything less than 34w is preterm labor)

🔑 The aim of preterm labor management is to delay DELIVERY and protect fetus— so give tocolytics
Also must give
1. IM betamethasone (prevent NRDS)
2. Magnesium (neuro protect)

⦙ no required intrapartum GBS prophylaxis because she has prenatal care (so GBS status is NOT unknown)

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2
Q

Mom at 27 weeks gestation is now in labor. She did not have routine prenatal care during pregnancy.

How do you manage?

A

🔑 27w gestation = pre-term labor (∴ anything less than 34w is preterm labor)

The aim of preterm labor management is to delay DELIVERY and protect fetus— so give tocolytics
Also must give
1. IM betamethasone (prevent NRDS)
2. Magnesium (neuro protect)
3. Intrapartum PENICILLIN prophylaxis (no prenatal care = unknown GBS status)

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3
Q

Mgmt spinal cord compression

A

IV glucocorticoids first
Then to MRI

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4
Q

Age of presentation of CVID

A

Normally age 20-40
But possible in anyone 10+

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5
Q

Management for ITP

A

1ˢᵗ IVIG (for 2-3d)
2ᴺᵈ prednisone
3ʳᵈ splenectomy

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6
Q

She’s for types of leukemia

A

Lymphoid leukemias — extreme ages old/young

Myeloid — middle age (40-60)

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7
Q

Auer rods

A

AML (specifically APML)

[note: t(15;17) translocation)

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8
Q

Leukemia treated with tyrosine kinase inhibitor

A

CML

[Note: Philadelphia chrom t(9;22) —> BCR-ABL fusion protein —> ↑s tyrosine kinase activity)

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9
Q

Leukocyte alkaline phosphatase (LAP)

A

↓ in CML

Compare
to

↑ in leukemioid reaction

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10
Q

CML

A
  • middle age
  • ↓ LAP
  • Philadelphia chromosome t(9;22) translocation —> BCR/ABL fusion protein —> ↑ tyrosine kinase activity
  • tx with tyrosine kinase inhibitor
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11
Q

Possible cardiac manifestations of Turners (4)

A

1) aortic dissection (severe CP)
2) aortic-root dilation (aortic regurgitation)
3) bicuspid aortic valve (aortic stenosis)
4) coarctation of the aorta,

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12
Q

MCC meningitis in a neonate (first 28 days of life)

A

Group b strept (s. Agalactiae)

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13
Q

Too 3 bugs causing meningitis in someone 60+ yo

A

1) s.pneumoniae
2) haemophilus influenziae
3) Listeria

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14
Q

Mechanism of celiacs to secondary hypeR-parathyroidism

A

Celiacs —> malabsorption of vits ADEK —> vitD deficiency —> impaired calcium absorption (↓ serum calcium) —> ↑ PTH (compensatory)

(Note: final calcium level will be mildly ↑ or normal, due to compensation)

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15
Q

Causes of secondary hyperparathyroidism

A

Chronic renal failure or other causes of vit D deficiency (like malabsorption: celiacs, chronic pancreatitis, cystic fibrosis, sprue)

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16
Q

Lab values in secondary hyperparathyroidism

A

Calcium — mildly raised or normal
Phosphate — high if CKD, low if other vitD deficiency
Vitamin D — low (primary disturbance)

17
Q

Placental abruption

A
  • present with 3rd trimester vag bleeding (only 80%) ⎮📍🌟20% have a concealed abruption (NO visible bleeding)
  • risk factors: cocaine, 📍 tobacco, HTN/📍 preeclampsia
  • 📍 high frequency contractions (< every 2-3 min apart)
  • 📍 tender firm uterus!
18
Q

CMV treatment

A

Ganiciclovir

19
Q

Intussusception

A
  • age 6-36 months old
    -preceding viral infection —> cause inflammation of intestinal lymphoid tissue (Peyers Patches) serve as lead point
    -pain abdomen — (pain is intermittent/episodic and colicky)
    -📍draws legs up to chest.
  • May vomit (first non-bilious, may become bilious with further obstruction)
  • gross bloody currant jelly stool
  • Possible palpable sausage shaped abdo mass.
    -U/S: shows “Target sign ” (this confirms the dx) & prompts immed tx with *AIR (or water-sol contrast/barium) ENEMA!
20
Q

Indications that a chronic ulcer is complicated by osteomyelitis (6)

A

-(1)chronic (present for *4+ weeks), or treatment-resistant (nonhealing) ulcer
-(2) local signs of infection (erythema, pus
-(3) large size *(📍2-cm), or deep (depth >3cm)
-(4) exposed bone tissue, or able to touch bone on bone-to-probe test
- (5) systemic signs (fever)
- (6)mark↑ESR

21
Q

Ulcer at the lateral malleolus and shin

A

Arterial ulcer

22
Q

Which ulcer is exudative, arterial or venous?

A

Venous

23
Q

Which ulcer (arterial or venous) has irregular borders and which looks “punched-out”

A

Irregular borders (venous)
“Punched-out” (arterial)

24
Q

Pathophysiology of amenorrhea during breastfeeding

A
25
Q

Lipid screening

A
  • start at age 35 (for men) & 40/45 (women)—> continue to monitor every 3-5y — until reach age 75
  • Consider earlier screening if family history of dyslipidemia or early MI, 🚬
26
Q
A

TCA toxicity

27
Q

TCA toxicity management

A
28
Q

Acute dystonia treatment

A

Benztropine or diphenhydramine

29
Q
A

Pityriasis Rosea

30
Q

NBS for a new thyroid nodule with ↓TSH

A

Radioactive iodine uptake/ iodine 131 scintigraphy

31
Q

Prochlorperazine

A

Antiemetic with D2 blocking activity (significance: can cause NMS)

32
Q

Promethazine

A

Antiemetic with D2 blocking activity (significance: can cause NMS)

33
Q

Antiemetics that can cause NMS (D2 blocking activity)

A

Metoclopramide
Prochlorperazine
Promethazine

34
Q

Which is seen in Crohns vs UC for the following:

Fissure
Stricture
Abscess
Fistula

A

Crohns — fissure, stricture, fistula

UC— abscess

35
Q

Tx for BPH

A

(1) alpha-1 blockers (tamsulosin, prazosin, dozazosin)
- quickly improves urine flow by relaxing smooth muscle
-Note: caution prazosin/doxazosin cause orthostatic hypOten

Long term— 5-alpha-reductive inhibitor (finesteride, dudasteride)
- for those with enlarged prostate experiencing urinary sx
- improves sx over several months by shrinking prostrate over time!

36
Q

Ogood shlatter

A
  • adolescent athlete
  • anterior knee pain
  • tibial tubercle traction apophysitis
37
Q

Which leukemia is contrasted with leukemiod reaction.
How?

A

CML — has ↓LAP

38
Q

Pre-renal AKI values for the following:

FeNa+
Urine Na+

A

FeNa+ (<1)

Urine Na+ (<20)

USMLE Step 2 CK (3 decks)

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