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USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


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  #301  
Old 01-31-2015
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Quote:
Originally Posted by 2cool4medschool View Post
Answer is E, I think an important part of the Q that you left out here was the Pulmonary Angiography -> Contrast induced nephropathy
Answer was E for sure, I could be wrong on my reasoning.
Her renal dysfunction did not occur now in hospital now but started 3 years ago and that could be prevented by prescribing anti-hypertensive medication ACE-I or ARB.

Rule of thumb don't presume what is not given in the vignette.
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  #302  
Old 02-05-2015
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[QUOTE=Asra Nayab;647154]section 1 item 25..

a 17 yr old girl comes to the physicia because of a 4 month history of persistent rash over her face and upper back. and there was a photo of a rash. Which of the following structures is primarily involved in the development of this rash?

a. apocrine glands
b. dermis
c. epidermal-dermal junction
d. panniculus
e. pilosebaceous follicles

its e. pilosebaceous follicles (got it right)
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  #303  
Old 02-05-2015
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[QUOTE=Asra Nayab;647066]section 4 item 28

a 51 yr old woman had a 15 minute episode of acute right sided chest pain and shortness of breath following insertion of a right subclavian catheter for hemodialysis. she is hospitalized for treatment of renal failure. her vitals =stable with no orthostatic hypotension. Hb 9. pulse oximetry = 94%. an xray chest shows 10% pneumothorax. the subclavian cathetar is in good position. which of the following is the most appropriate next step in management?
a. observation
b. CT scan of the chest
c. removal of the subclavian catheter
d. placement of chest tube
e. pleurodesis


ans : just observation, 15 % or less are generally absorbed on their own ,
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  #304  
Old 02-05-2015
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[QUOTE=starcrossed;409993]6 hour after cabg 62 y o M decrease systoloc BP fro 120/80 tp 100/85.urinary output decrease from 60 to 10. CO decease fro 6 to 3.Pulmonary artery diastolic pressure has increased.CXR shows widened mediastinum..ost paropriate next step?
A.administration of 2 ampules of sodium bicarb
B,epinephrine
C.placememnt of intra-aortic balloon
D.revision of coronary gaft
E.surgical exploration of the mediastin


ans is E, thoracic aortic rupture -widened mediastinum
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  #305  
Old 02-05-2015
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[QUOTE=dr mk;409457]Can some one plz ans and explain this ques-

A 27 year old nulligravid woman comes for a routine health maintenance examination. She is sexually active with one lifelong partner. She does not smoke. She has no history of stds. Pap smear now shows a high grade sq intraepithelial neoplasia. Prior pap smears have shown no abnormalities. Examination of the cervix and vagina shows no gross abnormalities. which of the following is the most appropriate next step in management?
A. repeat pap smear
B. HPV testing.
C. Colposcopy.
D. Cone biopsy of the cervix.
E. Random cervical biopsies.

are you sure you got colposcopy wrong? i think i too answered colposcopy and got it right
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  #306  
Old 02-05-2015
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[QUOTE=leo88;655186]
Quote:
Originally Posted by dr mk View Post

are you sure you got colposcopy wrong? i think i too answered colposcopy and got it right
I put colposcopy too and it was right.
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  #307  
Old 02-07-2015
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Remember HIV pts are more prone to TB and they have low CD4+lymphocytes.
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  #308  
Old 02-10-2015
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The links above for Nbme 7 are not working! I've exam in few days can anybody send Nbme 7 offline to mail id praty9@gmail.com
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  #309  
Old 02-22-2015
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Quote:
Originally Posted by nacht hund View Post
I remember that q from step 1 micro. Staph grows fast in hot environoment esp in potato, egg whatever salad with mayo ...you leave them outside on a hot day, they grow fast and they release toxin which made ppl puke. you leave in the fridge, they dont grow as fast, they dont release as much toxin. I got that q right
i wrote personal hygiene got it wrong

I'm sure its inherently dangerous food
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  #310  
Old 02-23-2015
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Quote:
Originally Posted by Midwesternblot View Post
60 year old man f/u 2 months after episode of UGI bleed from salicylate-induced ulcer. UGI series sows healed ulcer and type 1 sliding hiatal hernia. Which is most appropriate step in management?

I always thought asymptomatic hiatal hernias get medical management and observation. His previous ulcer seems resolved. If answer is Nissen, this seems a little drastic. What am I missing? Thanks!
In the absence of reflux disease, repair of a type I hernia is unnecessary

only symptomatic hernia, type II-IV gets surgery (transabdominal or transthoracic approach)

Nissen would be an answer for Rx resistant GERD
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  #311  
Old 02-23-2015
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Quote:
Originally Posted by microshara88 View Post
Cool thanks!

82 yo woman c breast CA who is cared for @ home has severe low back and left thigh pain for 5 days despite taking 5mg of morphine syrup every 4 hours. She says that morphine is moderately effective but loses its effectiveness 2-3 hrs after each dose....she is otherwise tolderating the morphine c/o side effects. Which of the following is most appropriate next step in pain mgmt?

a begin biofeedback
b refer pt for admission to hospital
c add acetaminophen to medication regiment
d continue the current dose of morphine and provide resssurance
e increase frequence of dose to q3hours
f swithc to subQ morphine 1 mg every 3 hours.


i know that C is wrong. what's biofeedback role in this? is that another word for Patient controlled analgesia?

don't know what right answer is.

thanks much in advance!
I wrote E and it's correct
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  #312  
Old 02-23-2015
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does anyone have explanations for these:





















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  #313  
Old 03-30-2015
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Could someone send me nbme form 7 and form 6, would appreciate it! email: tnachica@gmail.com. Thanks
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  #314  
Old 03-31-2015
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hey guys ..

did anyone get this Q right?

19 yo African American man with 9 month hx of watery diarrhea and abdominal cramps and bloating.. it has been worse since he started cole 1 year ago.. exam is normal:

A- bacterial overgrowth in the colon.
B- decreased bact. growth in the colon.
C- decreased bowel motility (got this wrong i thought it's IBS!)
D- digestive enzyme def.
E- immune damage to microvilli.




47 yo man with external haemorrhoid.. what's the diagnostic test?

A- tagged RBC
B- Anoscopy (got it wrong)
C- Colonoscopy
D- EGD
E- Flexible sigmoidoscopy


67 yo man with leg ulcer for 2 weeks. he had mitral valve replacement before 15 years for rheumatic valve disease. he takes foursomide and oral hypoglycemic. on exam, 5-cm ulcer with 3-mm red borders. there is moderate edema from toes to mid calf bilaterally. his feet are worm and pulses are weakly palpable. scattered crackles are heard at lung bases bilaterally. what's the diagnosis?

A- arterial insufficiency.
B- Endocarditis with mets infection.
C- Meleney ulcer (got it wrong, by exclusion)
D- mucormycosis
E- stasis dermatitis with ulcer.


please we want sure answers, not based on guessing.. thanks a lot
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  #315  
Old 05-12-2015
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hey guys can some one please send me name 7 ck. my exam is next week and just want to figure this out please again. thank you sparashuram29@gmail.com
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  #316  
Old 06-12-2015
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Hey guys
Does anyone remember the Q where there was an otherwise healthy woman who woke up in the morning with subconjunctival hemorrhage? (there was a Pic of an eye with a hemorrhage near the iris in that Q) I don't really remember all answer choices... only reassurance & slit lamp exam
i chose reassurance. Did anyone get this Q right? What was the answer?
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  #317  
Old 07-24-2015
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70 year old woman with peeling scaling and cracking of the right nipple for 2 months, eam shows no masses, mammography shows no masses or calcifications. Dx?
a. Ductal carcinoma in situ
b. Ductal ectasia
c. Eczema (wrong)
d. Inflammatory carcinoma
e. Intraductal papilloma
f. Mastitis
g. Lactiferous duct fistula
h. Pagets disease of the breast
i. Psyiologic discharge

See this link for difference between Pagets disease and Eczema

http://www.fastbleep.com/biology-notes/24/66/420
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  #318  
Old 01-09-2016
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Quote:
Originally Posted by els224 View Post
hey,
i wrote the answers in red in the quote
hope they're helpful!
thanks for your explanation. I still have questions about the kidney stone. Why can we discharge the patient without knowing how large the stone is? The pain subside is likely due to the pain relieve drug not the stone is passed.
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  #319  
Old 01-09-2016
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Can anyone pass me a copy of Form 7 ? lxhao1988@163.com
THANKS A LOT!
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  #320  
Old 01-11-2016
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if you have nbme 6 offline and answers ... can you plz send me a link
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  #321  
Old 01-12-2016
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Default reg nbme7

Hi,
kindly send me links to nbme 7
previous links not working
thanks
madhavi
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  #322  
Old 01-18-2016
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Hi all,

Thanks for your help in reviewing questions. If someone has offline for nbme 6/7, can you please send it to me? Greatly appreciated thanks
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  #323  
Old 03-27-2016
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12 month old boy with 4 hour h/o high temp 40.6C and irritability. He had two previous infections during the past 8 months; pneumococcal bacteremia at 4 months, periorbital cellulitis by H.influenzae type B at 7 months. Immunizations up to date. LP done, CSF show WBC count of 500/mm3 with 95% segmented neutrophils. Gram stain of CVS shows gram positive diplococci. The cell type most likely involved in the underlying condition is:
A. B Lymphocyte
B. Dendritic
C. Macrophage
D. Mast
E. Monocyte
F. Neutrophil
G. T lymphocyte
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  #324  
Old 05-28-2016
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Quote:
Originally Posted by asthula View Post
Her renal dysfunction did not occur now in hospital now but started 3 years ago and that could be prevented by prescribing anti-hypertensive medication ACE-I or ARB.

Rule of thumb don't presume what is not given in the vignette.
The answer is for sure E because that's what I put and I got it right.

While its's true that she does have chronic kidney disease, the question tells you that her baseline creatinine is 2.2 and her current creatinine is 3.6. Plus it asks how you could have prevented her ACUTE deterioration specifically.
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  #325  
Old 06-02-2016
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Thanks for all the help!
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  #326  
Old 09-29-2016
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[QUOTE=leo88;655178]
Quote:
Originally Posted by starcrossed View Post
6 hour after cabg 62 y o M decrease systoloc BP fro 120/80 tp 100/85.urinary output decrease from 60 to 10. CO decease fro 6 to 3.Pulmonary artery diastolic pressure has increased.CXR shows widened mediastinum..ost paropriate next step?
A.administration of 2 ampules of sodium bicarb
B,epinephrine
C.placememnt of intra-aortic balloon
D.revision of coronary gaft
E.surgical exploration of the mediastin


ans is E, thoracic aortic rupture -widened mediastinum
Why is this answer surgical exploration? How'd you come to that conclusion. Just curious on the thought process.
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  #327  
Old 11-28-2016
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Default Nbme 7

Hi everyone,
I need answers of NBME 7 urgently!!
thanks
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  #328  
Old 11-28-2016
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Hi everyone,
I need answers of NBME 7 urgently!!
thanks
dr_ahmed_hanafy@yahoo.com
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