Repeated USMLE Questions Step 2 CK | Review

Q- A 32-year-old woman presents with fatigue and pruritus. Labs show elevated alkaline phosphatase and positive anti–mitochondrial antibodies.

What is the most appropriate initial treatment?

A- Azathioprine

B- Prednisone

C- Ursodeoxycholic acid

D- Vitamin K

C- Ursodeoxycholic acid- Primary biliary cholangitis presents with pruritus, cholestatic labs, and anti-mitochondrial antibodies. Ursodeoxycholic acid slows disease progression.

Q- A 70-year-old hospitalized patient suddenly develops dyspnea and hypotension. CT angiography confirms a massive pulmonary embolism.

What is the most appropriate treatment?

A- Aspirin

B- Intravenous heparin only

C- Systemic thrombolysis

D- Warfarin therapy

C- Systemic thrombolysis- Massive PE with hemodynamic instability requires systemic thrombolysis (e.g., alteplase). Anticoagulation alone is insufficient in unstable patients.

Q- A 24-year-old man presents with fever, sore throat, and severe fatigue. Examination shows posterior cervical lymphadenopathy and splenomegaly. The heterophile antibody test is positive.

Which of the following is the most important management recommendation?

A- Begin amoxicillin therapy

B- Avoid contact sports

C- Start antiviral therapy

D- Start corticosteroids

B- Avoid contact sports- Infectious mononucleosis can cause splenic enlargement, increasing the risk of rupture. Patients should avoid contact sports for several weeks.

Repeated USMLE Questions Step 2 CK- Review- 58

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