Usmle World Step 2

Front 1

ACE INHIBITOR SIDE EFFECTS

Back 1

CAPTOPRIL

Cough (kinins)
Angioedema
Pregnancy (teratogenic)
Taste change
O - hypOtension
Proteinuria
Rash
Increased renin
Low AT II

HYPERKALEMIA!

Front 2

Can reduce the risk of hepatic injury by acetaminophen by competing with CYP2E1

Back 2

Acute alcohol intake (chronic intake increases chance of injury by decreasing glutathione)

Front 3

Lyte abnormality caused by acetozolamide

Back 3

Normal anion gap metabolic acidosis

Front 4

How do dx achalasia (3 tests)

Which one is confirmatory

Back 4

Barium studies
Esophagoscopy
Manometry - CONFIRMATORY

Front 5

Rx for comedons

What do you add if reactivation

Back 5

Topical retinoids

Add topical erythromycin or benzoyl peroxide

Front 6

Rx for papulary and inflammatory acne

Back 6

Oral doxycycline

Front 7

Rx for nodular and scaring acne

Back 7

Oral isotretinoin

Front 8

slowly progressing , non tender, indurated
mass, which evolves into multiple abscesses, fistula, and draining sinus tracts with
sulfur granules, which appear yellow

Whats the treatment

Back 8

Cervical actinomycosis (actinomyces israelii)

Rx - high dose IV pcn for 6-12 weeks, followed by surgical debridement (ABX FIRST)

Front 9

Acute onset of naseau, vomiting, abdominal pain and hypoglycemia and
hypotension after a stressful event (surgery) in a pt who is steroid dependant

Back 9

ACUTE ADRENAL INSUFFICIENCY

ALWAYS THINK WITH PRE OP STEROID USE

Front 10

Pt ingested alkali in attempted suicide- your actions?

Back 10

First do contrast GI studies to r/o perforation (NOT x ray - would not show perforation), then can do diagnostic peritoneal lavage but ALWAYS RULE OUT PERFORATION FIRST

Front 11

Most pelvic abscesses are due to _

Back 11

Ruptured appendicitis

Front 12

Acute bacterial prostatitis - what's the cause

How do you manage? What's contraindicated?

Back 12

Young - Chlamydia and Gonorrhea

Old - E coli

Do culture + start empiric abx

DO NOT do prostatic massage to prevent sepsis

Front 13

Muddy brown granular casts - dx?
Most likely cause?

Back 13

ATN

Hypotension

Front 14

WBC cast in urine (2)

Back 14

Pyelonephritis

Interstitial nephritis

Front 15

Fatty cast in urine

Back 15

Nephrotic syndrome

Front 16

Broad and waxy cast in urine

Back 16

Chronic renal failure

Front 17

Anti viral drug, Can cause crystalluria with renal tubular obstruction during high dose parenteral therapy, especially in inadequately hydrated pts.

Back 17

Acyclovir

Front 18

Acid base disturbance in aldosterone defficiency

Back 18

non-anion gap hyperkalemic, hyponatremic metabolic acidosis

Front 19

80% of pt have primary adrenal deficiency due to

Back 19

Autoimmune adrenalitis

Front 20

MC cause of adrenal insufficiency in underdeveloped countries

Back 20

TB

Front 21

presence of Endometrial glands in the uterine muscle.

Back 21

Adenomyosis

Front 22

Enlarged symmetrical uterus + menorrhagia + dysmenorrhea

Back 22

Adenomyosis

Front 23

Treatment of choice for adjustment disorder

Back 23

Cognitive or psychotherapy

Front 24

Major pathological findings of alcoholic liver disease(3)

Back 24

Fatty liver (steatosis)
Alcoholic hepatitis
Alcoholic fibrosis/cirrhosis

Front 25

Liver biopsy shows Mallory bodies, infiltration by neutrophils,liver cell necrosis, and a perivenular distribution of inflamation

Back 25

Alcoholic liver

Front 26

Positive Periodic Acid Shiff
reaction (PAS

Back 26

ALL

Front 27

transient recurrent pulmonary infiltrates, peripheral
eosinophilia, asthma and immediate wheel and flair reaction to Aspergilus
fumigatus and presence of antibodies in serum against AF

Back 27

Allergic Bronchopulmonar Aspergillosis

Front 28

recurrent bacterial infection and markedly elevated IgE.
Infections are due to Staph and are SKIN infections. Neutrophils exihibit impaired
chemotaxis. Other features are eczema, asthma, allergic rhinitis.

Back 28

JOB SYNDROME

Front 29

Triad of eczema,thrombocytopenia, pyogenic recurent infections. IgA & IgE are high while IgM is low

Back 29

WISKOT ALDRICH

Front 30

Allergic interstitial nephritis - which drug causes , what type of hypersensitivity

Back 30

Nafcillin

Type IV

Front 31

fever,petechial rash and peripheral eosinophilia in an azotemic (Increased Urea) pt

Back 31

Allergic interstitial nephritis

Front 32

MC cause of low AFP

Back 32

Gestational age error

Front 33

High levels of MSAFP - what are you thinking about

Back 33

Omphalocele, gastroschisis

Front 34

protein that increased only in neural tube defects

Back 34

ACHE

Front 35

High level of MSAFP - what do you do next

Back 35

First do US, then amniocentesis

Front 36

Triple test

Back 36

MSAFP
B HCG
Unconjugated estriol

Front 37

Decreased MSAFP + Increased b-hCG + Decreased UE3

Back 37

DOWNS

Front 38

Decreased MSAFP + Decreased b-hCG + Decreased UE3

Back 38

TRISOMY 18

Front 39

Alpha 1 AT defficiency - whats the risk

Back 39

Panlobular emphysema

Front 40

Hepatocytes contain granules that are PAS positive and Diastase resistant + cirrhosis

Back 40

Alpha 1 AT defficiency

Front 41

Recurent episodes of Hematuria, sensoryneural deafness and a family hx of renal
disease. Alternating areas of thinned and thickened capilary loops with spliting of
GBM.

Back 41

ALPORTS

Front 42

Amiodarone toxicity (4)

Back 42

PULMONARY (contraindicated in restrictive lung disease)
Hepatotoxicity
Skin reaction
Corneal deposits

Front 43

Amphotericine causes which lyte disturbance

Back 43

HYPOKALEMIA

Front 44

a woman with chronic HA, almost everyday, who presents
for Hematuria

Back 44

Analgesic nephropathy - hematuria is due to papillary necrosis

Front 45

MC cause of descending aortic aneurysm

Back 45

ATHEROSCLEROSIS

Front 46

pt with absence of risk factors of CAD, night pain waking her
up, transient ST elevation, absence of Q waves and negative cardiac enzymes

Back 46

PRINZMETAL ANGINA - vasospasm

Front 47

DOC for Prinzmetal angina

If doesnt work what do you add

Back 47

DILTIAZEM

If doesnt work add nitrates (ASA and propranolol are CONTRAINDICATED)

Front 48

Adolescent male with frequent epistaxis, nasal obstruction, HA and conductive hearing loss, has greyish red mass in posterior nasopharynx

Back 48

Angiofibroma

Front 49

Pt post MVA there is anesthesia below level of injury but preserved posterior column function

Back 49

Anterior cord syndrome

Front 50

Dystonia, an extrapyramidal
SE of Haloperidol is treated with_

Back 50

Benztropine or diphenhydramine

Front 51

Common SE of SSRI - how do you fix

Back 51

Sexual dysfunction, d/c SSRI and start Bupropion

Front 52

Antidepressant thats also good for insomnia

Back 52

Trazodone