High Yield Facts Usmle Step 2 Ck First Aid

Front 1

ECG finding in atrial flutter

Back 1

sawtooth P waves

Front 2

Definition of unstable angina

Back 2

angina occuring at rest, new or worsening

Front 3

Anti-HTN med for pt w/ proteinuria

Back 3

ACE-I

Front 4

Beck's Triad for cardiac tamponade

Back 4

JVD, muffled heart sounds, hypotension

Front 5

Drugs that slow AV node transmission

Back 5

BBs, CCBs, digoxin

Front 6

Tx for hypercholesterolemia that causes flushing and puritis and treatment for that side effect

Back 6

Tx- niacin, have pt take NSAIDs/Aspirin prior to niacin

Front 7

Treatment for A-fib

Back 7

rate control - BBer's, CCBers- ditilazem/verapamil
rhythm control- amiodarone
anticoagulation -warfarin (bridge w/heparin)
cardioversion if acute or no thrombus (echo)

Front 8

Tx for V-fib

Back 8

immediate cardioversion

Front 9

Autoimmune complication of MI occuring 2-4 wks after

Back 9

Dressler's syndrome - pericarditis, fever, inc ESR

Front 10

Pt w/ h/o IVDU now has JVD and holosystolic murmur at left sternal border, what do they have?

Back 10

Right sided heart failure- tricuspid regurge

Front 11

Murmur and diagnostic test for HOCUM

Back 11

Murmur- harsh blowing systolic @ LLSB that decreases w increased venous return (better when squatting, worse when standing)

Front 12

Pulsus paradoxus

Back 12

Fall in systolic BP > 10 mm Hg with inspiration (cardiac tamponade)

Front 13

ECG findings in pericarditis

Back 13

low-voltage, diffuse ST-segment elevation

Front 14

Hypertension defintion

Back 14

BP>140/90 on three separate occasions, 2wks apart

Front 15

Eight surgically correctable causes of HTN

Back 15

Hyperthyroidism, hyperparathyroidism, coarctation of aorta, renal artery stenosis, renal parenchymal disease, Cushing's disease, Pheochromocytoma, Conn's syndrome (adenoma that makes aldosterone)

Front 16

Pt has pulsatile abdominal mass/bruit what test do you do?

Back 16

US and CT

Front 17

When do you repair AAA

Back 17

symptomatic, ruptured, symptomatic or > 5.5 cm

Front 18

Tx for acute coronary syndrome (ie you suspect pt has MI)

Back 18

"B-MOAN-ing"
B-bblocker, M-morphine, O-O2, A-aspirin,
N-nitroglycerine....and Heparin

Front 19

Metabolic syndrome (6 features)

Back 19

Abdominal obesity, high TG's, low HDL, HTN, insulin resistance, prothrombotic/proinflammatory states

Front 20

What is the appropriate diagnostic test for 50 YO male w/ angina that can exercise just fine

Back 20

Excercise stress test on treadmill w/ ECG

Front 21

What is the appropriate diagnostic test for 65 YO woman who has OA but needs her heart checked out

Back 21

Pharmacologic stress test w/ dobutamine

Front 22

Target LDL in pt w/ diabetes

Back 22

< 70

Front 23

Signs of ischemia during stress test

Back 23

angina, ST segment changes, dec BP

Front 24

ECG findings that suggest an MI

Back 24

ST changes, flattened T-waves, Q waves (will appear later, can also signify old MI)

Front 25

Young pt has angina at rest with ST-segment changes but normal cardiac enzymes. Diagnosis and treatment

Back 25

Prinzmental's agina, treat with CCBers

Front 26

Common sx in "silent MI" (women, elderly, diabetics)

Back 26

CHF, shock, AMS

Front 27

Diagnostic test for pulmonary embolism

Back 27

helical CT w/ IV contrast (UWorld) or V/Q scan (FA)

Front 28

Med to reverse heparin

Back 28

Protamine

Front 29

Coagulation parameter affected by Warfarin and Vit K dependent clotting factors

Back 29

1972 WEPT - 10, 9, 7, 2 -are Vit K dependent and affected by W-warfarin, E-extrinsic pathway, PT - measure PT

Front 30

Young pt with fam hx of sudden death collapes and dies while exercising/sports

Back 30

Hypertrophic cardiomyopathy

Front 31

Endocarditis prophylaxis who needs it and what do you give

Back 31

Fake valves or h/o endocarditis - give amox before oral surgery

Front 32

Signs of peripheral vascular disease
6 Ps of ischemia

Back 32

Pallor, pain, pulselessness, paralysis, paresthesia, poikilothermia (cold)

Front 33

Virchow's triad

Back 33

hypercoaguable state (pregnant, OCPs), stasis, endothelial dmg

Front 34

Most common cause of HTN in young women

Back 34

OCPs

Front 35

Most common cause of HTN in young men

Back 35

EtOH

Front 36

Lesion with "stuck on appearance"

Back 36

seborrheic keratosis

Front 37

Lesion with red plaques / silver-white scales/ sharp margins

Back 37

psoriasis

Front 38

Most common cause of skin cancer (most common malignancy in human kind!) pearly, telangiectasias, can have uclerating/bleeding quality also

Back 38

basal cell carcinoma

Front 39

Honey crusted lesions

Back 39

Impetigo - staph aureus, or GABS, can use PO erythromycin or topical mupirocin

Front 40

Derm condition - febrile pt w/ DM that has painful, swollen lower extremity, pt might also have athlete's foot

Back 40

Cellulitis

Front 41

Positive nikolsky's sign (skin rubs off easily)

Back 41

Pemphigus vulgaris- the vulgar pimp, just vulgar doesn't get that deep (epidermal layer)

Front 42

Neg Nikolsky's sign (skin doesn't rub off)

Back 42

Bullous Pemphigoid - the ballsy pimp, (IgG)et (C3) times deeper (Subepidermal)

Front 43

55 YO obese pt with dirty velvety patches on skin

Back 43

acanthosis nigricans, insulin resistance

Front 44

Dermatomal distributed lesions, painful

Back 44

zoster

Front 45

Flat topped papules

Back 45

lichen planus

Front 46

Target lesions

Back 46

Erythema multiforme- can be due to HSV, drugs etc...DO NOT CONFUSE w/ erythema migricans: annular rash w/ area of central clearing seen in lyme disease/borrelia/ticks/doxycycline

Front 47

Lesion on skin that's been in contact with metal/jewlerly

Back 47

contact dermatitis

Front 48

herald patch, christmas tree pattern

Back 48

pityriasis rosea

Front 49

16 YO with annular patch of stubby, broken hair, alopecia

Back 49

alopecia areata

Front 50

pink, scaling flat lesions, chest/back, KOH - spaghetti and meatballs

Back 50

pityriasis versicolor

Front 51

Melanoma characteristics

Back 51

asymmetrical, irregular border, color variation, large

Front 52

premalignant lesion from sun exposure can lead to squamous cell carcinoma, sandpaper

Back 52

actinic keratosis, elderly, h/o sun exposure

Front 53

Lesion that is like "a dewdrop on a rose petal"

Back 53

chickenpox

Front 54

craddle cap

Back 54

seborrheic dermatitis, antifungals

Front 55

associated with propionibacterium acnes, changes in androgen levels

Back 55

acne vulgaris, first line tx is face wash, use accutate if nodular cystic

Front 56

painful recurrent vesicular erruptions

Back 56

HSV

Front 57

inflammation/epithelial thinning of anogenital area, white, paper, may have fusion of labia in post menopausal women

Back 57

lichen sclerosus, do valvula biopsy just to be sure then give steroids

Front 58

Exophytic nodules on skin w/ varying degrees of scaling/ulceration,

Back 58

squamous cell carcinoma

Front 59

Most common cause of hypothyroidism AND what cancer are these pts at risk for? And other fun facts...

Back 59

Hashimotos, + anti TPO abs, @ risk for thyorid lymphoma, cold scan (dec uptake), always check thyroid fcn in pts w/ low Na, inc serum CK or hyperlipidemia

Front 60

Dx of pt with exopthalmos, pretibial myxedma and dec TSH

Back 60

Graves

Front 61

Most common cause of Cushing's

Back 61

Iatrogenic steroids, second most common is cushing's disease (pituitary adenoma)

Front 62

Pt with hypo-Ca signs (perioral tingling, trousseaus-carpal spasm w/ BP cuff, chvostek sign - facial nerve spasm) AND high phos, low PTH

Back 62

Hypoparathyroidism- give Ca and vit D

Front 63

Stones, bones, groans, psychiatric overtoans

Back 63

hyperCa most common cause are adenoma or hyperplasia of glands, can also occur in pts with ESRD - Ca AND serum phos will be high

Front 64

Pt with HA, weakness, polyuria with HTN and tentany on exam. Labs show inc Na, low K and metabolic alkalosis. Diagnosis?

Back 64

Hyperaldosteronism (Conn's--> aldosterone secreting tumor or bilateral adrenal hyperplasia)

Front 65

Pt with tachy, fluctuating BP, HA, diaphoreisis, AMS, and panic. Diagnosis?

Back 65

Pheochromocytoma

Front 66

Alpha or Beta antagonists for pheochromocytoma treatment?

Back 66

Alpha antagonists - phentolamine, phenoxybenzamine

Front 67

Pt with h/o lithium use now presents with copius amts of dilute urine

Back 67

Nephrogenic DI - Kidney will not be responsive to ADH.

Front 68

Anti-diabetes med assoc with lactic acidosis

Back 68

metformin

Front 69

Pt with weakness, n/v/wt loss, skin pigmentation. Labs- hypoNa and hyperK. Diagnosis / tx

Back 69

addison's disease (primary adrenal insufficiency), tx is glucocorticoids, mineralcorticoids, IV fluids (fluticasone)

Front 70

Goal Hemoglobin A1c for pt with DM

Back 70

<7.0

Front 71

Treatment for DKA

Back 71

IVF, insulin, replace 'lytes (ie K)

Front 72

Why should you NOT use BB-ers in diabetics?

Back 72

Can mask sx of hypoglycemia

Front 73

Pt with severe onset of diffuse abdnl pain. +Peritoneal signs, and XR shows free air under diaphram. What do you do next?

Back 73

Laprascopy to repair perforation

Front 74

Most likely cause of acute lower GI bleed in pts >40 YO often in sigmoid LLQ area

Back 74

Diverticulosis/itis

Front 75

Diganositic test when US is non-confirmatory for cholecystitis

Back 75

HIDA scan

Front 76

Sential loop on XR is associated with....

Back 76

Acute pancreatitis

Front 77

Risk factors for gallstones

Back 77

female, fat, forty, fertile