I am going to answer the sample USMLE Step 2 CK Questions with Explanations. These questions are available at USMLE.org
A 30-year-old man comes to the office to establish primary care. His medical history is unremarkable and he takes no medications. His father had a myocardial infarction at the age of 48 years. The patient has smoked one-half pack of cigarettes daily for 10 years. He does not drink alcoholic beverages. He is 168 cm (5 ft 6 in) tall and weighs 82 kg (180 lb); his BMI is 29 kg/m2. Vital signs are within normal limits. The patient is not in distress. Physical examination discloses no abnormalities. Smoking cessation is recommended.
Which of the following is the most appropriate screening study for this patient at this time?
(A) ECG
(B) Fasting serum lipid studies
(C) Serum chemistry profile
(D) No screening studies are indicated
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Answer
Given the patient’s history and risk factors, the most appropriate screening study at this time is:
(B) Fasting serum lipid studies
This is recommended because:
- Family history of premature coronary artery disease: His father had a myocardial infarction at age 48, which places the patient at higher risk.
- Smoking: He has a significant smoking history, which increases the risk of cardiovascular disease.
- BMI: His BMI is 29 kg/m², which is categorized as overweight and can contribute to cardiovascular risk.
Screening for lipid levels will help identify any dyslipidemia that could further increase his risk of cardiovascular disease, allowing for early intervention. Regular monitoring and managing lipid levels can help in reducing the risk of future cardiovascular events.
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