Repeated USMLE Questions Step 2 CK | Review

Q- A 59-year-old man presents with crushing chest pain for 1 hour. ECG shows ST elevation in the anterior leads. The hospital does not have a catheterization laboratory, and transfer would take 3 hours.

What is the most appropriate next step?

A- Administer fibrinolytic therapy

B- Begin aspirin therapy only

C- Start intravenous heparin and observe

D- Wait for the transfer for PCI

A- Administer fibrinolytic therapy- If PCI cannot be performed within 120 minutes, fibrinolytic therapy should be given for STEMI to restore coronary perfusion.

Q- A 66-year-old man with cirrhosis presents with increasing abdominal distension and fever. Paracentesis reveals neutrophil count of 350 cells/mm³.

What is the most appropriate treatment?

A- Intravenous ceftriaxone

B- Oral metronidazole

C- Paracentesis only

D- Prednisone

A- Intravenous ceftriaxone- Spontaneous bacterial peritonitis (SBP) is diagnosed when ascitic neutrophils are ≥250 cells/mm³. Immediate treatment with third-generation cephalosporins is required.

Q- A 30-year-old woman presents with severe unilateral headache, nausea, and photophobia. She has experienced similar episodes in the past. Neurologic examination is normal.

What is the most appropriate acute treatment?

A- Acetaminophen

B- Propranolol

C- Sumatriptan

D- Topiramate

C- Sumatriptan-Triptans are first-line therapy for acute migraine attacks. Beta-blockers and topiramate are used for migraine prevention.

Repeated USMLE Questions Step 2 CK- Review- 61

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