Repeated USMLE Questions Step 2 CK- Review- 15

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Q- A patient presents to the clinic complaining of progressive proximal muscle weakness. Examinations reveals periorbital heliotrope rash and erythema on her face, neck and upper chest. Which of the following is most likely markedly elevated in this patient?

A- Creatinine phosphokinase

B- Rheumatic factor

C- Serum creatinine

D- Serum sodium

A- Creatinine phosphokinase- This is a case of dermatomyositis confirmed by the presentation of periorbital heliotrope rash and proximal muscle weakness. CPK is usually markedly elevated in these patients. Other choices should be normal. Muscle biopsy would confirm the diagnosis.



Q- A 35-year-old woman is taking oral contraceptive pills for 5 years. Which one of the following risks is higher in this patient?

A- Ectopic pregnancy

B- Endometrial cancer

C- Inflammatory pelvic disease

D- Venous thromboembolism

D- Venous thromboembolism- Women who take OCP esp. relatively older age have high risk of developing stoke, MI and blood clots. They have lower risk of endometrial cancer than other women and ectopic pregnancy and IPD are not related to OCP administration.



Q- Which one of the following should be given to a newly-born baby of a mother who has a positive hepatitis B surface antigen (HBsAg) test?

A- Hepatitis B immunization

B- Hepatitis B immunoglobulin (HBIG)

C- Hepatitis B immunization and HBIG

C- Hepatitis B immunization and HBIG- Both are given to the baby to prevent infection. Hepatitis B infection can be prevented  in 95% of these cases.



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