Repeated USMLE Questions Step 2 CK- 482

Q- A-62- old woman presents to the ER in coma. Examination reveals temp of 90 F, pulse of 50, blood pressure of 100/60 and diffuse hyporeflexia. Thyroid gland is enlarged.

What is the best next step?

A- Begin intravenous fluids

B- Intravenous levothyroxine and glucocorticoid

C- Obtain T4 and TSH and wait for results

D- Rapid rewarming

B- Intravenous levothyroxine and glucocorticoid- This is a case of myxedema coma. It is an emergency. IV thyroid hormone and corticoid should be administered as soon as possible. T4 and TSH should be done first but it is wrong choice because we cannot wait for the results. Slow rewarming, not rapid is also important and intravenous fluids should be following as well.

Q- Which of the following is the LEAST factor can lead to urinary tract infection?

A- Diabetes mellitus

B- Pregnancy

C- Prolonged tetracycline therapy

D- Urinary tract obstruction

C- Prolonged tetracycline therapy- This leads to frequency of urination and large amount of urine rather than urinary tract infection.

Q- Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging?

A- Cytomegalovirus infection

B- Down syndrome

C- Huntington’s disease

D- Toxoplasmosis

A- Cytomegalovirus infection- Calcification only occurs in CMV and toxoplasmosis but they are scattered in the cortex in toxoplasmosis.

2 thoughts on “Repeated USMLE Questions Step 2 CK- 482”

  1. Thanks so much. Your name is close to my daughter Lydia. I am also proud of you.

  2. am proud of u..

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