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Repeated USMLE Questions Step 2 CK- 476



Q- You are the physician in charge of a nursing home where several patients develop influenza A symptoms. None of the residents received flu vaccine yet.

What is the best next step of action?

A- Administer flu vaccine to all residents

B- Administer flu vaccine plus oseltamivir for 2 weeks to all residents

C- Administer oseltamivir for 2 weeks to all residents

D- Treat only patients with oseltamivir until their symptoms subside

B- Administer flu vaccine plus oseltamivir for 2 weeks to all residents- This looks like influenza outbreak. Full attention is needed for the risk of pneumonia in elderly patients. Vaccine and treatment for all is recommended to avoid mass infection. 



Q- A fireman presents to the ER with headache and dizziness after putting out a fire. Which of the following is the best first step of action?

A- Check carboxyhemoglobin level

B- Obtain CT scan of the head

C- Obtain EKG

D- Obtain MRI of the brain

A- Check carboxyhemoglobin level- CO poisoning is common in these situations. Early diagnosis is life-saving. 



Q- A 23-year-old nursing student presents with confusion, fatigue and sweating. Her blood sugar is 40 mg/dL. Lab tests show a high insulin level and a very low C peptide level. Which of the following is the most likely diagnosis?

A- Factitious hypoglycemia

B- Insulinoma

C- Reactive hypoglycemia

D- Pheochromocytoma

A- Factitious hypoglycemia- Low C peptide is the clue of exogenous insulin. This patient injected herself with insulin to fake hypoglycemia 



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