Repeated USMLE Questions Step 2 CK- Review- 41

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Q- A 25-year-old woman presents with sudden-onset shortness of breath and pleuritic chest pain. She started oral contraceptive pills 3 months ago. On exam, she is tachycardic and has mild hypoxia. CT pulmonary angiography shows multiple filling defects.

Which of the following is the best initial treatment?

A- Aspirin

B- Heparin infusion

C- Thrombolysis

D- Warfarin

B- Heparin infusion- Acute pulmonary embolism requires immediate anticoagulation with unfractionated or low molecular-weight heparin. Warfarin is for long-term therapy. Thrombolysis is reserved for massive PE with hemodynamic instability.

 

Q- A 30-year-old man presents with fever, malaise, and sore throat. On exam, he has generalized lymphadenopathy, hepatosplenomegaly, and a maculopapular rash after taking ampicillin.

Which one of the following tests is most helpful for diagnosis?

A- Anti-streptolysin O titer

B- HIV ELSA

C- Monospot antibody test

D- Throat swab culture

C- Monospot antibody test- The clinical presentation suggests infectious mononucleosis (EBV infection). The heterophile antibody (Monospot) test confirms the diagnosis. Ampicillin rash is a classic clue.

 

Q- A 6-year-old boy presents with recurrent respiratory infections, failure to thrive, and foul-smelling, bulky stools. The sweat chloride test is positive.

Which complication is most likely in this patient?

A- Bronchiectasis

B- Early-onset colon cancer

C- Renal failure

D- Rheumatic heart disease

A- Bronchiectasis- The child has cystic fibrosis, which predisposes to chronic lung infections and bronchiectasis due to impaired mucociliary clearance.

 

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