NBME USMLE STEP 2 CK 2024 EXAM REVIEW
WITH 400 EXAM QUESTIONS AND ANSWERS
(100% CORRECT ANSWERS) NBME CBSE (STEP
2) REAL EXAM QUESTIONS LATEST VERSION
2024 GRADED A+ (NEW!!)
Classic ECG finding in pericarditis - ANSWER-Low-voltage, diffuse ST-segment elevation
Definition of hypertension - ANSWER-BP > 140/90 on 3 separate occasions 2 weeks apart
Eight surgically correctable causes of HTN - ANSWER-Renal artery stenosis, coarc of aorta, pheo, Conn's, Cushing's syndrome, unilateral renal parenchymal dz, hyperthyroid, hyperparathyroid
Evaluation of pulsatile abdominal mass and bruit - ANSWER-Abdominal U/S and CT
Indications for surgical repair of abdominal aortic aneurysm - ANSWER- >5.5cm, rapidly enlarging, symptomatic, ruptured
Treatment for acute coronary syndrome - ANSWER-ASA, heparin, clopidogrel, morphine, oxygen, sublingual nitro, IV beta-blockers
Metabolic syndrome - ANSWER-Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states
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Appropriate diagnostic test: 50yo male with stable angina can exercise to 85% of maximum predicted heart rate - ANSWER-Exercise stress treadmill with ECG
Appropriate diagnostic test: 65yo female with LBBB and severe OA has unstable
angina - ANSWER-Pharmacologic stress test (e.g. dobutamine echo)
Target LDL in a patient with diabetes - ANSWER- <70mg/dL
Signs of active ischemia during stress testing - ANSWER-Angina, ST-segment changes on ECG or decreased BP
ECG findings suggestive of MI - ANSWER-ST-segment elevation (depression means ischemia), flattened T waves, Q waves
Coronary territories in MI - ANSWER-Anterior wall (LAD/diagonal), inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal)
A young patient with angina at rest and ST-segment elevation with normal cardiac enzymes - ANSWER-Prinzmetal's angina
Common symptoms associated with silent MIs - ANSWER-CHF, shock, AMS
Diagnostic test for PE - ANSWER-Spiral CT with contrast
Protamine - ANSWER-Reverses effects of heparin
Classic EKG finding in atrial flutter - ANSWER-"Sawtooth" p waves 2 / 4
Definition of unstable angina - ANSWER-Angina that is new, is worsening, or occurs at rest
Antihypertensive for a diabetic patient with proteinuria - ANSWER-ACEI
Beck's triad for cardiac tamponade - ANSWER-Hypotension, distant heart sounds, and JVD
Drugs that slow heart rate - ANSWER-Beta-blockers, CCBs, digoxin, amiodarone
Hypercholesterolemia treatment that leads to flushing and pruritus - ANSWER- Niacin
Murmur - hypertrophic obstructive cardiomyopathy - ANSWER-A systolic ejection murmur heard along the lateral sternal border that increases with decreased preload (i.e. Valsalva maneuver)
Murmur - aortic insufficiency - ANSWER-Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases with increased afterload (i.e. handgrip)
Murmur - aortic stenosis - ANSWER-A systolic crescendo/decrescendo murmur that radiates to the neck; increases with increased preload (i.e. squatting)
Murmur - mitral regurgitation - ANSWER-A holosystolic murmur that radiates to the axillar; increases with increased afterload (handgrip)
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Murmur - mitral stenosis - ANSWER-A diastolic, mid to late, low-pitched murmur preceded by an opening snap
Treatment for atrial fibrillation and atrial flutter - ANSWER-If unstable, cardiovert. If stable or chronic, rate control with CCBs or beta-blockers
Treatment for ventricular fibrillation - ANSWER-Immediate cardioversion
Dressler's syndrome - ANSWER-An autoimmune reaction with fever, pericarditis and increased ESR occurring 2-4 weeks post-MI
IV drug use with JVD and holosystolic murmur at left sternal border. Treatment? - ANSWER-Treat existing heart failure and replace tricuspid valve
Diagnostic test for hypertrophic cardiomyopathy - ANSWER-Echocardiogram (showing a thickened left ventricular wall and outflow obstruction)
Pulsus paradoxus - ANSWER-A decrease in systolic BP of > 10 mmHg with inspiration; seen in cardiac tamponade
Prothrombin time - ANSWER-Coagulation parameter affected by warfarin
A young patient with FHx of sudden death collapses and dies while exercising - ANSWER-Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens - ANSWER-Oral surgery - amoxicillin for certain situations; GI or GU procedures - not recommended
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