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USMLE Step 2 CK Bits & Pieces High yield short focused points, monographs, charts, illustrations, tables, and other stuff related to the USMLE Step 2 CK Exam.


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  #1  
Old 06-10-2011
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Arrow High Yield Images for Step 2 CK

High Yield images for the Step 2 CK exam

I will be adding more to this thread.

If you know more please post your replies and add to the list.

Sarcoidosis

High Yield Images for Step 2 CK-sacroidosisxray.jpg
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Lobar Pneumonia (Stept Pneumonia)

High Yield Images for Step 2 CK-streppneumo.jpg
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Lyme Disease (Erythema Chronicum Migans)

High Yield Images for Step 2 CK-rash.jpg
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Hypertensive Retinopathy

High Yield Images for Step 2 CK-hypertensive-retinopathy.jpg
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Key distinguishing features are “copper wiring” (increased retinal arteriole light reflex), and arteriovenous (AV) nicking (arteriolar-venular crossing defects). Cotton wool spots and hemorrhages are seen in both diabetic retinopathy and hypertensive retinopathy.
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Old 06-10-2011
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Default corkscrew sign in midgut volvulus!

Corkscrew Sign of midgut volvulus

High Yield Images for Step 2 CK-volvolus-cork-screw.jpg
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Default Good collection!

This post is useful too!

Pediatric Radiological Signs
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Sturge-Weber syndrome

High Yield Images for Step 2 CK-sturge-weber.jpg
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The bilateral port wine stain involves the V1, V2, and V3 regions and the right V3.

Adenoma Sebaceum

High Yield Images for Step 2 CK-adenoma-sebaceum.jpg
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Adenoma sebaceum in patient with tuberous sclerosis
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Old 06-13-2011
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Default NF-cafe' au lait spots!

There are two main types of Neurofibromatosis known as NF1 and NF2. The former also goes under the name of Von Recklinghausen’s disease and the latter as bilateral acoustic NF. Of the two NF1 is the most common.
The symptoms for NF1 will usually present in early childhood and one of the telltale signs is the appearance of coffee coloured birthmarks commonly referred to as café-au-lait spots. These spots are actually present when the child s born but increase in size, number and pigmentation during the first few years of the child’s life.

High Yield Images for Step 2 CK-cafeautlait.jpg
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Old 06-13-2011
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Default Axillary freckling! NF-1!

High Yield Images for Step 2 CK-axillary-freckling.jpg
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Default Kayser-Fleischer ring Wilson's disease!

High Yield Images for Step 2 CK-kfring.jpg
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Default Oral surgeon-herpetic whitlow! Treatment-topical acyclovir!

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Old 07-01-2011
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Default Some other images

Corneal enlargement in congenital glaucoma
High Yield Images for Step 2 CK-glaucoma_corneal_enlrgmnt.jpg
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Anterior dislocation of the shoulder (Humeral head out of glenoid)
High Yield Images for Step 2 CK-shoulder_ant_dl_ap_xr.jpg
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Hereditary hemorrhagic telangectasia (Osler Weber Rendu syndrome) with small telangectasias in the mouth, on the tongue and lips
High Yield Images for Step 2 CK-osler_weber_rendu.jpg
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Viral conjunctivitis (with conjunctival injection without purulent discharge)
High Yield Images for Step 2 CK-viral_conjunctivitis.jpg
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Testicular appendix torsion with a blue spot at the anterosuperior aspect of the testis
High Yield Images for Step 2 CK-appendix_testis_torsion.jpg
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High Yield Images for Step 2 CK-muconium.jpg
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Failure to pass meconium should suggest the presence of either meconium ileus or Hirschsprung disease. The barium enema reveals a dilated proximal colon and a sudden transition to a narrow distal colon, which is highly suggestive of Hirschsprung disease
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High Yield Images for Step 2 CK-double-bubble.jpg
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The X-ray reveals the classic double-bubble appearance of duodenal atresia. One bubble is caused by the gas-filled stomach and the other is caused by a dilated proximal duodenum.
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High Yield Images for Step 2 CK-iron-deficiency-blood-film.jpg
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The peripheral blood smear shows hypochromic, microcytic red blood cells (RBCs) consistent with iron deficiency
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High Yield Images for Step 2 CK-talipes-equinovarus.jpg
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Talipes Equinovarus,a common form of clubfoot. Manipulation and serial casting is the mainstay of treatment for this congenital deformity
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High Yield Images for Step 2 CK-hyrdrocele.jpg
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Newborn with large right hydrocele
Physical findings:
Scrotal distention (testicle may be impossible to palpate)
Transillumination
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High Yield Images for Step 2 CK-mongolian-spot.jpg
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several mongolian spots. They are often confused with the bruises of child abuse, but unlike bruises, mongolian spots take months to years to fade. They classically are described as flat blue or gray macules with variable margins

Last edited by USMLE-Syndrome; 07-20-2011 at 12:52 PM.
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Tension pneumothorax

High Yield Images for Step 2 CK-tension-pneumothorax.jpg
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Old 07-21-2011
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High Yield Images for Step 2 CK-empetigo.jpg
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nonbullous impetigo, a superficial bacterial infection transmitted by direct contact. Nonbullous impetigo is caused by group A β-hemolytic Streptococcus pyogenes
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Default Gastroschisis

High Yield Images for Step 2 CK-gastroschisis.jpg
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Gastroschisis

The defect is in the abdominal wall and results in protrusion of abdominal viscera without protective sac. The defect is always right sided and the umbilical ring is normal.
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Default trisomy 18 (Edwards syndrome)

High Yield Images for Step 2 CK-edward-syndrome.jpg
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The characteristically clenched overlapping fingers seen in the image are highly specific for trisomy 18 (Edwards syndrome)
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Old 07-26-2011
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High Yield Images for Step 2 CK-hyaline-membrane-disease.jpg
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Infant with hyaline membrane disease. Note the granular lungs, air bronchogram, and air-filled esophagus. Anteroposterior (A) and lateral (B) roentgenograms are needed to distinguish the umbilical artery from the vein catheter and to determine the appropriate level of insertion
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High Yield Images for Step 2 CK-ewind-sarcoma.jpg
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Radiograph of tibial Ewing sarcoma showing periosteal elevation or "onion-skinning.
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Old 07-28-2011
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The X-ray reveals bowel loops in the left hemithorax. This is pathognomonic of a congenital diaphragmatic hernia.
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chest radiograph showing hyperexpansion, marked peribronchial shadowing, bronchial wall thickening, and ring shadows all strongly indicate a diagnosis of cystic fibrosis

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Old 07-28-2011
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Default Henoch-Schönlein Purpura



HSP due to an immune vasculitic reaction typically presents with a rash on the lower extremities and buttocks
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Voiding cystourethrogram (VCUG) showing grade IV right vesicoureteral reflux with intrarenal reflux.
grade 4 involves more dilitation and tortuosity of the ureters and more calyceal blunting than grade 3.
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acute bronchiolitis,
the chest radiograph shows hyperinflation of the lungs with flattening of the diaphragm, horizontal ribs, and increased hilar bronchial markings. RSV is the most commonly isolated agent
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sarcoidosis
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rickets.
The ends of the radius and ulna are expanded, rarefied, and cup shaped and the bones are poorly mineralized

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a single palmar crease in a newborn is most closely associated with
Down syndrome.
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Old 08-03-2011
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Basal Cell Carcinoma
In contrast to SCCs and actinic keratoses, there is no precursor skin lesion for BCCs. These lesions may have an appearance that varies from nodules in the skin to a large nonhealing sore with drainage and crusting. In comparison to SCCs, they have a slow growth rate, which can lead to a delay in diagnosis.
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Barium enema in patient with cecal volvulus. The contrast stops abruptly at the proximal end of the hepatic flexure (arrowhead). The dilated, air-filled cecum crosses the midline of the abdomen toward the left upper quadrant (arrows)
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The X-ray demonstrates a greenstick fracture of both the radius and ulna. A greenstick fracture occurs when the bone is bent and only one side of the bone fractures, leaving the other side cortically intact.
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Default hepatic abscess




CT is the imaging modality of choice for detecting a hepatic abscess and demonstrates low attenuation ill-defined lesion(s). Air-fluid levels may also be present.
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child has a retinoblastoma, the most common ocular tumor in children. It presents with leukokoria, a white pupillary reflex that replaces the usual red reflex
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utaneous melanoma warrants a biopsy, and a punch biopsy is the most accepted method. The critical factor in performing a biopsy with a suspicion of melanoma is assessment of the depth of invasion. A punch biopsy is the better choice when compared to a shave biopsy.
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Old 08-07-2011
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EEG of hypsarrhythmia in infantile spasms. There is a chaotic background of slow-wave activity with sharp components. This is pathognomonic for infantile spasms.
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child has idiopathic avascular necrosis (Legg-Calve-Perthes disease) of the left hip. It usually affects boys 5–10 years of age and presents with the insidious onset of limp and antalgic gait, and loss of internal rotation and abduction of the hip.
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Anteroposterior radiograph of the right hip of an 8-yr-old boy with Legg-Calvé-Perthes disease. There is a collapsed yet dense capital femoral epiphysis with early fragmentation. The small medial triangle of the capital femoral epiphysis is uninvolved in the disease process.
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Pelvic radiographs demonstrating development dysplasia of the left hip. A, The Hilgenreiner method for identification of dysplasia of the hip before ossification of the capital femoral epiphysis; α' is greater than α, indicating greater obliquity of the acetabular roof. d', is greater than d, indicating lateral displacement of the femur. h is greater than h', indicating cephalad displacement of the femur. These relationships indicate dysplasia of the patient's left hip. B, Developmental dislocation of the left hip. The bony roof of the left acetabulum is quite oblique, and there is the beginning of a false acetabulum above its most lateral aspect. The left femur is displaced laterally and superiorly. The ossification center of the left capital femoral epiphysis is smaller than that of the right.
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candidal fungal infection, as in this figure showing pseudohyphae with prominent cell walls characteristic of the organism.

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The chest radiograph shows loops of bowel in the chest and displacement of the mediastinum indicating diaphragmatic hernia. Upon first suspicion of a diagnosis of diaphragmatic hernia, a nasogastric tube should be passed to decompress the stomach and to avoid visceral distention.

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Default children gestated during untreated maternal hypothyroidism.



Macroglossia and coarse facial features are seen. These findings along with hyperreflexia and a slow return phase are typical for
children gestated during untreated maternal hypothyroidism.
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This child is exhibiting the dramatic harlequin color change. It is a benign event and lasts anywhere from a few seconds to half an hour. The pathogenesis is unknown, but occurs more frequently in preterm infants. Thus, it is hypothesized that it is the result of the immaturity of the autonomic nervous system and its regulation of cutaneous blood flow.



sharply demarcated erythematous zone on the dependent side with blanching of the skin on the nondependent side
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. Autoimmune congenital heart block is the most probable diagnosis. As the name implies, mothers of children with this syndrome have an increased incidence of certain autoimmune disorders. Anti-Ro antibodies are present in more than 90% of mothers of newborns with isolated heart block, and approximately 5% of children born to mothers with anti-Ro antibody have heart block.

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staphylococcal scalded skin syndrome (SSSS)
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Osteogenesis imperfecta
, a condition resulting from abnormal type I collagen that manifests as fragile bones. This newborn likely has Type I, which presents at birth with blue sclera, in utero fractures, moderate bone fragility, conductive hearing loss and mild short stature.
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the crescentic shape of a subdural hematoma. Subdural hematomas are more common in the elderly because the superficial bridging vessels have a greater distance to travel because of brain atrophy and consequently, are easier to rupture
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Kayser-Fleischer ring.
It is the result of deposition of copper in Descemet membrane and is present in many cases of Wilson disease. Wilson disease is an autosomal recessive disorder of copper metabolism and results in accumulation of copper in the liver and brain. Laboratory evaluation reveals low serum copper, low serum ceruloplasmin and elevated copper stores on liver biopsy.
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Congenital melanocytic nevi
are present in approximately 1% of newborn infants. These nevi have been categorized by size: giant congenital nevi are more than 20 cm in diameter (adult size), small congenital nevi are less than 2 cm in diameter, and intermediate nevi are in between in size.


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Please keep them coming. Great revision aid when tired of staring at books
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light bulb sign .... posterior shoulder dislocation
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Saint ésprit éclaire nous
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Excellent work..........!
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Wow Wow Wow

Very nice job , thank you very much , Sehr Dank , Merci beaucoup , شكرا جزيلا
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Default Jejunal atresia

"Triple bouble " reflects gas trapping in stomach, duodenum,jejunum. + gassless colon.
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Default necrotizing enterocolitis

Red arrows point to linear bands of radiolucency which parallel the wall of the
bowel indicating the presence of pneumatosis intestinalis in necrotizing enterocolitis
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Default Bullous myringitis

Bullous myringitis is painful inflammation blisters of the tympanic membrane (myringa being Latin for "eardrum") and surrounding deep canal skin with the formation of serum or blood filled bullae.
Organisms are same as for otitis media, although thought to be a/w mycoplasma pneumoniae.
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Quote:
Originally Posted by USMLE-Syndrome View Post
Attachment 1787
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The X-ray reveals the classic double-bubble appearance of duodenal atresia. One bubble is caused by the gas-filled stomach and the other is caused by a dilated proximal duodenum.
Triple bubble sign is seen in proximal jejunal atresia which may be present in fetus exposed to cocaine in utero
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Quote:
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Barium enema in patient with cecal volvulus. The contrast stops abruptly at the proximal end of the hepatic flexure (arrowhead). The dilated, air-filled cecum crosses the midline of the abdomen toward the left upper quadrant (arrows)
Cecal volvulus has kidney bean appearance and hemicolectomy is the treatment of choice
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Quote:
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Attachment 1830
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Gastroschisis

The defect is in the abdominal wall and results in protrusion of abdominal viscera without protective sac. The defect is always right sided and the umbilical ring is normal.



Omphalocele have a sac with the intestinal contents and is a midline wall defect whereas Gastroschiasis don't have a sac and is a lateral wall defect.
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THANKS for the post
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