Repeated USMLE Questions Step 2 CK- Review- 42

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Q- A 35-year-old man presents with palpitations, sweating, and episodic headaches. Blood pressure is persistently high. Urinary catecholamines and metanephrines are elevated.

Which of the following is the best initial management before surgery?

A- ACE inhibitor

B- Alpha-blocker

C- Beta-blocker

D- Calcium channel blocker

B- Alpha-blocker- In pheochromocytoma, alpha-blockade (phenoxybenzamine) must be given before beta-blockade to prevent hypertensive crisis.

 

Q- A 23-year-old woman presents with fever, dysuria, and flank pain. She has costovertebral angle tenderness. Urinalysis shows WBC casts.

Which of the following is the most likely diagnosis?

A- Acute cystitis

B- Acute pyelonephritis

C- Interstitial nephritis

D- Renal papillary necrosis

B- Acute pyelonephritis- Fever, flank pain, and WBC casts are classic for acute pyelonephritis. Cystitis lacks WBC casts.

 

Q- A 64-year-old man presents with crushing chest pain radiating to his left arm. ECG shows ST-elevation in V1-V4.

Which of these arteries is most likely occluded?

A- Left anterior descending artery

B- Left circumflex artery

C- Posterior descending artery

D- Right coronary artery

A- Left anterior descending artery- ST-elevation in V1-V4 is diagnostic for anterior wall MI, which is most likely due to LAD occlusion.

 

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4 thoughts on “Repeated USMLE Questions Step 2 CK- Review- 42”

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