UWorld Step 2 CK Form 1

Question 1

True or false: TPN must be administered through a central line.

Answer 1

False

TPN can be administered in a peripheral line, but only for < 48 hours due to the stress of the osmotic load.

Question 2

What do variable FHRs look like?

Answer 2

• The nadir of depression is varying early and late.

* There are accelerations and decelerations.

Question 3

Black-based, painless ulcers after chemotherapy = ______________.

Answer 3

ecthyma gangrenosum

Question 4

True or false: HSV encephalitis causes no changes in CSF.

Answer 4

False

It classically looks like a milder form of viral meningitis: lymphocytosis, normal glucose, and elevated protein.

Question 5

Differentiate protraction of labor from arrest of labor (and what to do in each).

Answer 5

•Protraction:

• Inadequate cervical change/effacement (e.g., only 1 cm in two hours)
• Treat with oxytocin

•Arrest:

• No change in cervical dilation/effacement
• Treat with C-section

Question 6

Why should you not do amniotomy with a high fetal presentation?

Answer 6

The cord can get caught.

Amniotomy is contraindicated in fetal stations higher than -2.

Question 7

True or false: you need to receive both PNA vaccines every five years.

Answer 7

False

The 13-valent kind is needed only once.

Question 8

How should you treat SVC syndrome from small cell carcinoma?

Answer 8

Radiation

SCC is “exquisitely sensitive” to radiation (though it returns).

Question 9

Bullous pemphigoid commonly affects what demographic?

Answer 9

Those older than 60

Question 10

In which women would you recommend prenatal vitamins AND folic acid prior to pregnancy?

Answer 10

Those with a history of NTDs

If a woman has a child with anencephaly, for example, taking folic acid in addition to the folic acid that is in prenatal vitamins will decrease the risk of future NTDs.

Question 11

Polymyalgia rheumatica preferentially attacks _____________.

Answer 11

the hips and shoulders

Question 12

True or false: the frontal lobe needs to be involved to have motor involvement after a seizure.

Answer 12

False

Todd’s paralysis can result from any kind of seizure.

Question 13

Automatism and blank staring are features of seizures in the ______________.

Answer 13

temporal lobes

Question 14

Infants of diabetic mothers (all types of diabetes) are at increased risk of which three things?

Answer 14

• Preterm delivery
• Respiratory distress
• Macrosomia

Question 15

What birth defects are specific to pregestational diabetes?

Answer 15

• Cardiac (transposition of the great vessels, ASD)

* NTDs

Question 16

Dysmorphic RBCs in urine are suggestive of what type of renal problem?

Answer 16

Glomerular

Anything distal to the glomerulus can cause bleeding, but the RBCs will not be dysmorphic.

Question 17

Those with ESRD typically have what kind of parathyroid abnormality?

Answer 17

Parathyroid hyperplasia

Recall that ESRD leads to hypocalcemia and hyperphosphatemia. Both of those electrolyte abnormalities result in increased PTH secretion. This can be confusing because they look hypoparathyroid by labs: low Ca, high Phos.

Question 18

What does this pattern of signs/symptoms indicate?
•Hematemesis
•Dark green stools
•Hypotension

Answer 18

Iron toxicity

Look for the vignette with a little kid getting into his anemic mom’s purse.

Question 19

Cavitary lung lesions, fever, and vertebral fractures could indicate?

Answer 19

Tuberculosis

Don’t think that bone pain plus lung lesion equals cancer. Pott’s disease can cause this. Further, fever is not commonly seen in cancer.

Question 20

Meniscus tears commonly result from _______________.

Answer 20

twisting injuries

Question 21

What do you feel when you have a torn meniscus?

Answer 21

• Inability to extend the knee fully

* Pain with weight bearing

Question 22

Describe the treatment of CLL.

Answer 22

Treatment is done only when the person is symptomatic (such as developing secondary cytopenias, B symptoms, LAD, etc.). If the person is completely asymptomatic, treatment is deferred.

Rituximab is often used.

Question 23

First-line treatment for torticollis?

Answer 23

Diphenhydramine

Question 24

If a woman with PCOS desires pregnancy, the best first-line treatment is ______________.

Answer 24

weight loss

Question 25

Mid-shaft fracture of the humerus is likely to injure what structure?

Answer 25

Radial nerve

The brachial artery is more commonly injured in humeral fractures above the elbow.

Question 26

Treatment of pruritus secondary to pancreatic cancer is best done with _____________.

Answer 26

endoscopic stent placement

Question 27

When you see a GI malabsorption problem and the person is from a third-world country, look for _____________ as a way of checking for parasitism.

Answer 27

eosinophilia

Question 28

Per the USPSTF, lipid screening should be done every ________ years.

Answer 28

5

Question 29

A man is having an MI. What is the physiologic mechanism for the first-line treatment for reducing his pain?

Answer 29

Venous dilation (NO)