Repeated USMLE Questions Step 2 CK | Review

Q- A 28-year-old woman presents with palpitations and tremor. ECG shows atrial fibrillation. Labs reveal suppressed TSH and elevated T4.

What is the most appropriate initial treatment?

A- Methimazole

B- Propranolol

C- Radioactive iodine therapy

D- Thyroidectomy

B- Propranolol- In hyperthyroidism with atrial fibrillation, the first step is beta-blocker therapy to control adrenergic symptoms and heart rate before definitive therapy.

Q- A 35-year-old man presents with fever, hypotension, and a diffuse rash after a minor surgical procedure. Labs show elevated creatinine and liver enzymes. Blood cultures are pending.

What is the most likely diagnosis?

A- Anaphylaxis

B- Septic shock due to gram-negative bacteria

C- Toxic shock syndrome

D- Viral exanthem

C- Toxic shock syndrome- Toxic shock syndrome is caused by toxin-producing Staphylococcus aureus or Streptococcus pyogenes, presenting with fever, hypotension, rash, and multi-organ involvement.

Q- A 49-year-old man presents with progressive dysphagia to solids over the past several months. He has lost 15 pounds. He has a 30-pack-year smoking history.

What is the most appropriate next diagnostic test?

A- Barium swallow

B- Chest CT scan

C- Esophageal manometry

D- Upper endoscopy

D- Upper endoscopy- Progressive dysphagia with weight loss suggests esophageal cancer. Upper endoscopy with biopsy is the best initial diagnostic test.

Repeated USMLE Questions Step 2 CK- Review- 60

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