Step 2 CK NBME Form 2 (Offline) Answer Key

Step 2 CK NBME Form 2


Block 1

1. B (well-fitted shoes to avoid trauma. prophylactic antibiotics not indicated.)
2. A (clue from the stem: hyperthyroidism, irregularly irregular pulse, variation in intensity of S1)
3. C
4. E (hereditary spherocytosis)
5. B
6. E (NSAID papillary necrosis doesn't happen so fast. History of trauma makes E best answer)
7. C (DT boosters indicated after every 10 years. She has all 5 doses of DTP already, so now booster is with adult DT even if she is 16 year old.)
8. C (SIADH can happen secondary to meningitis)
9. D (Hemochromatosis)
10. A (identifiable stressor)
11. J
12. H
13. D (renal artery stenosis)
14. A (HTN with hypokalemia >> Conn's syndrome)
15. D
16. B (fixed splitting of S2)
17.
18. D (refractile body at bifurcation of retinal artery >> cholesterol emboli from the internal carotid artery atherosclerotic disease >> duplex scan of carotid artery)
19. A
20. C
21. A
22. B
23. A
24. B
25. A [Pt has a crude pincer grasp- This should have been mastered by 9-14 months to be normal]
26. E
27. C
28. C (only option that goes with restrictive disease)
29. D
30. G
31. D
32. B (fat soluble vitamin)
33. E
34. A
35. C
36. A (antibiotic prophylaxis for Chronic bacterial prostatitis)
37. F
38. A (Huntington's disease)
39. G
40. A (cyclosporine-induced hypertension)
41. E
42. B
43. E (obesity >> increased estrogen)
44. C (crossed hemiplegia)
45. B
46. F

BLOCK 2

1. D (pin-point pupils >> opiates)
2. B
3. A (Lyme disease)
4. D (Granulosa cells produce excessive amounts of estrogen)
5. C
6. D
7. B (Elevating the left testicle relieves the pain >> Epidodymitis)
8. D (side effect of enalapril)
9. D (Heparin-induced thrombocytopenia. As explained by a commenter: the reason there is thrombocytopenia in HIT is because the Heparin-Platelet4 complex are attacked by IgG in the human bodies that essentially activate the platelet and thus form clots. These clots are the reason free platelets are low.)
10. C
11. B (pulsus paradoxus)
12. D
13. C (biliary colic)
14. C (Oral isotretinoin is never the first option for acne, only used when topical treatments have failed)
15. B
16. C
17. B (screening of lipid profil routinly done for every HTN patient)
18. A
19. B
20. E
21. F
22. D
23. D
24. E (white patches over the skin that become more distinct with Wood's lamp examination "ash leaf spots" >> Tuberous sclerosis)
25. D
26. I
27. B
28. E
29. B
30. D
31. E
32. B
33. B (question stem says that mother applies sunscreen 'just before she goes swimming', which is incorrect way. It should be applied at least 15-30 min before sun exposure)
34. A (Botulism)
35. A
36. D (VSD)
37. E
38. D
39. D
40. B
41. C
42. E
43. D
44. E
45. C
46. D

Block 3

1. D
2. A
3. C
4. B
5. A
6. A (aldolase-B deficiency)
7. B
8. D
9. D (risk of repeated falls)
10. B (Xanthelasma >> high cholestrol)
11. E
12. B
13. D (Prinzmetal angina)
14. A
15. C (Diabetes Inspidus)
16. E
17. C (I am confused between Conversion and Malingering, because there is possibly a motive [she doesn't want to move] but it isn't clearly stated either. So on revising the question, I am now more tilted towards Conversion.)
18. G
19. C (Patient has febrile neutropenia >> IV antibiotics)
20. B
21. E (Surgery to relieve obstruction)
22. B
23. C
24. B
25. H
26. E
27. C
28. D
29. G (Cardiac tamponade)
30. A
31. D (CMV infection)
32. D
33. C (Herpes zoster)
34. C (adrenal crisis)
35. B
36. C
37. B
38. F (Isoniazid >> B6 deficiency)
39. E
40. D (Warfarin contraindicated in pregnancy)
41. E
42. F
43. D
44. B
45. C
46. D (tension pneumothorax >> decreased venous return)

Block 4

1. A (breath holding spell >> reassurance)
2. A (RR shows a relationship but p value is statistically insignificant)
3. B
4. E (anaphylaxis)
5. E (high clinical suspicion with low-probability VQ scan >> angiography)
6. F
7. C (multiple areas of increased and decreased uptake >> MNG)
8. G
9. C (acute presentation makes aortic valve rupture more likely than congestive heart failure)
10. B (in a terminally ill patient, the priority is pain control)
11. A (erythema toxicum >> self-limiting condition)
12. C (MR, large testes >> fragile X syndrome)
13. E (Digoxin toxicity)
14. E
15. F (previous episodes of a sudden decline of cognitive functioning >> multi-infarct dementia)
16. C
17. E (delirium tremens)
18. D
19. J (proximal muscle weakness, polymyositis is one of the causes)
20. E
21. E
22. D (Mitral stenosis; most common cause RHD)
23. E (Mastitis: antibiotics, continue breast feeding)
24. A (Ephedrine is a sympathomimetic drug. For the treatment of hypotension during spinal anesthesia.)
25. B (Metoprolol improves mortality in heart disease)
26. F
27. D (Chronic Granulomatous disease)
28. D (S4 points towards MI)
29. D
30. A
31. C (thiazide diuretic >> gout)
32. B
33. D (GI obstruction >> NG tube first step)
34. D (HTN in young patient >> look for renal artery stenosis)
35. A (Malignancy related hypercalcemia fits best: Depression, Muscle weakness and fatigue, decreased tendon reflex, weight loss. Hypothyroidism wouldn't account for the weight loss.)
36. A
37. C (insulin and glucose >> fastest way to lower down serum K)
38. E (she is asymptomatic, no treatment at this point is indicated)
39. D (intussusception >> contrast enema both diagnostic and therapeutic)
40. C (ectopic pregnancy)
41. D
42. D
43. C
44. A (Hepatic artery complications are very common following liver transplant in children.)
45. A (http://pediatrics.aappublications.org/content/65/6/1125.abstract)
46. C