Repeated USMLE Questions Step 2 CK- 484

Q- Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment?

A- Blood urea nitrogen (BUN) rises 6 mg/dL

B- Hematocrit drops by 4%

C- Random serum glucose of 70 mg/dL

D- Serum amylase of 900 IU/L

A- Blood urea nitrogen (BUN) rises 6 mg/dL- Poor prognostic signs of acute pancreatitis 24-hour after hydration and treatment are increased BUN by 5% or more, decreased hematocrit value by 10% and high serum glucose. Serum amylase is not considered a prognostic sign.

Q- A patient presents with itching on his arms and legs for 2 weeks. Erythematous plaques covered with silvery scale are seen on his legs and back of his arms. Which of the following treatment most likely improves this condition?

A- Oral acetaminophen

B- Oral amoxicillin

C- Topical betamethasone

D- Topical mupirocin

C- Topical betamethasone- This is most likely a case of psoriasis which is characterized by hyperproliferation of keratinocytes and inflammatory cellular infiltrate. It is treated by topical steroids such as betamethasone.

Q- A young boy presents with echolalia, frequent eye blinking, repetitive frowning and head shaking to the left. These movements subside when he answers the questions or clears his throat. Which of the following is the most likely diagnosis?

A- Epilepsy

B- Huntington disease

C- Parkinsonism

D- Tourette syndrome

D- Tourette syndrome- Echolalia is repetition of another person’s words in a meaningless way. Tic disorder is characterized by echolalia and other movements mentioned in this scenario.

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